Self-harm incidence among children and young people 2019-2023: time series analysis of electronic health records in Greater Manchester, England.

Hussey, Louise Jane; Kontopantelis, Evangelos; Kapur, Nav; Williams, Richard; Mok, Pearl; Ashcroft, Darren M; Garg, Shruti; Chew Graham, Carolyn; Lovell, Karina; Webb, Roger Thomas

Abstract

BackgroundThe mental health of children and adolescents has declined in recent years. Self-harm is frequently an expression of this psychological distress.ObjectivesTo examine trends in self-harm incidence among 10-24-year olds between January 2019-December 2023.MethodsWe conducted time-series analyses of all incident episodes of self-harm among 10-24-year olds using the Greater Manchester Care Record. The observation period was split into four phases: pre-pandemic (1/2019-2/2020); pandemic phase 1 (3/2020-6/2021); pandemic phase 2 (7/2021-12/2022) and post-pandemic (1/2023-12/2023). Rate ratios by sex, age, ethnicity and Indices of Multiple Deprivation were modelled using negative binomial regression.FindingsSelf-harm incidence rates decreased significantly in the post-pandemic phase, compared with the pre-pandemic period (male-incident rate ratios (IRR) 0.72; 95% CI 0.62 to 0.84, female IRR 0.85; 95% CI 0.74 to 0.99). In females, this followed increased rates, rising by 18% in pandemic phase 2 (IRR 1.18; 95% CI 1.04 to 1.34). In males, rates decreased throughout the study period. Incidence rates were lowest for 10-12 year olds. However, the greatest increase was observed in this age group, with rates in pandemic phase 2 being almost two times that seen pre-pandemic for females (IRR 1.91; 95% CI 1.47 to 2.48). The change in rates among females was also most marked in the least deprived neighbourhoods, rising by more than 50% (IRR 1.54; 95% CI 1.21 to 1.95) in pandemic phase 2.ConclusionsOur results indicate a decrease in self-harm incidence during 2023. Analysis by age group showed the greatest increase in rates in 10-12-year olds. Further research is needed to confirm these findings and to identify the mechanisms driving these trends.

Citation

Hussey, L. J., Kontopantelis, E., Kapur, N., Williams, R., Mok, P., Ashcroft, D. M., Garg, S., Chew Graham, C., Lovell, K., & Webb, R. T. (2025). Self-harm incidence among children and young people 2019-2023: time series analysis of electronic health records in Greater Manchester, England. BMJ Mental Health, 28(1), Article e301615. https://doi.org/10.1136/bmjment-2025-301615

• Journal Article Type: Article
• Acceptance Date: May 16, 2025
• Online Publication Date: Jun 9, 2025
• Publication Date: Jun 1, 2025
• Deposit Date: Jun 23, 2025
• Publicly Available Date: Jun 23, 2025
• Journal: BMJ mental health
• Electronic ISSN: 2755-9734
• Peer Reviewed: Peer Reviewed
• Volume: 28
• Issue: 1
• Article Number: e301615
• DOI: https://doi.org/10.1136/bmjment-2025-301615
• Keywords: Anxiety Disorders, Child & Adolescent Psychiatry, Suicide & Self-harm, Depression & Mood Disorders, Covid-19, Humans, Incidence, Self-Injurious Behavior, Adolescent, Child, England, Female, Male, Young Adult, Electronic Health Records, COVID-19
• Public URL: https://keele-repository.worktribe.com/output/1280716
• Publisher URL: https://mentalhealth.bmj.com/content/28/1/e301615
• PMID: 40490272