%0 Journal Article
%T Self-harm and rurality in Canada: an analysis of hospitalization data from 2015 to 2019.
%A Mahinpey N
%A Pollock NJ
%A Liu L
%A Contreras G
%A Thompson W
%J Soc Psychiatry Psychiatr Epidemiol
%V 58
%N 8
%D Aug 2023 8
%M 37029322
%F 4.519
%R 10.1007/s00127-023-02463-7
%X OBJECTIVE: The incidence of self-harm is an important indicator in suicide surveillance and a target outcome for suicide prevention. Self-harm rates vary by geographic location and rurality appears to be a risk factor. The objectives of this study were to estimate rates of self-harm hospitalization in Canada over a 5-year period by sex and age group, and examine relationships between self-harm and rurality.
METHODS: Hospitalizations related to self-harm were identified in a national dataset (the Discharge Abstract Database) for all patients aged 10 years or older who were discharged from hospital between 2015 and 2019. Self-harm hospitalization rates were calculated and stratified by year, sex, age group, and level of rurality, as measured using the Index of Remoteness. A Poisson regression was fit to estimate rate ratios for the levels of rurality.
RESULTS: Rates of self-harm hospitalization were higher for females than males across all levels of rurality and increased with each level for both sexes, except for among young males. The widest rural-to-urban disparities were observed for the 10-19 and 20-34-year old age groups. Females aged 10-19 in very remote areas had the highest self-harm hospitalization rate.
CONCLUSIONS: The rate of self-harm hospitalization in Canada varied by sex, age group, and level of rurality. Clinical and community-based interventions for self-harm, such as safety planning and increased access to mental health services, should be tailored to the differential risks across geographic contexts.