Citation

Mehlum L. Acta Psychiatr. Scand. 2022; 145(4): 317-318.

Copyright

(Copyright © 2022, John Wiley and Sons)

DOI

10.1111/acps.13402

PMID

35263444

Abstract

Self-harm, commonly defined as self-poisoning or self-injury irrespective of intent,1 is an increasing public health problem in most countries, particularly among the young people. Evidence for this comes from both data from national registers2 based on hospital data and population surveys.3 Of all known risk factors for completed suicide, self-harm is the strongest and this fact alone should make it a high priority for health authorities and clinicians to dedicate attention and resources to more systematically and effectively treat people who have self-harmed as an integral element of national strategies for suicide prevention. In most countries, however, there is a severe lack of systematic approaches that could meet the needs of this population. Not that we do not use sizeable healthcare resources in the treatment of self-harm. As evident from the new study from Denmark by Dyvesether et al4 in the present issue of Acta Psychiatrica Scandinavica, patients presenting to hospitals after self-harm incur very high direct costs in addition to the significant clinical challenges they offer clinicians in terms of their large numbers and with respect to the assessments and treatments they need to be offered. If we add to this, the cost of healthcare and social security in the wake of hospital treatment, indirect costs to society through loss of productivity, the human cost through lives lost and suffering for families and the patients themselves, the societal cost of self-harm is alarming.

Still, there has been a remarkable lack of studies on the cost of self-harm and suicidal behaviour, the economic aspects of treatment and the savings that could potentially be made through adopting more cost-effective interventions. This makes the new Danish study so important since it is the first to provide a national estimate of somatic and psychiatric hospital costs of treatment of patients presenting to hospital with self-harm. This was made possible given Denmark's national and publicly funded hospital system covering the entire population and the national registers providing detailed information about hospital treatment and related costs on the individual patient's level. The study has many interesting features, but a main finding is simply that it so clearly shows how high the costs associated with self-harm are. An annual amount corresponding to nearly 60 million USD in a small country like Denmark is extremely high. In addition, it is reasonable to ask whether the money is well spent...

Language: en