Short summary

A scoping review will identify the registered incidence rate of suicide attempts and self-harm in Europe when comparing the different definitions used.

A qualitative study will identify how registration practice of suicide attempts and self-harm currently is in Denmark.

A cohort study will identify how the health care sector is used by adolescents and see if there have been changes over time that we should be aware about in relation to suicidal behavior.

Rationale

Suicide behaviour is a major concern with the general healthcare system worldwide. In Denmark, 600 people commit suicide every year while more than 4,000 suicide attempts occur.

Centre for Suicide Research in Denmark has systematically registered suicide attempts since 1989 to match the definition made by WHO. In the validation process between 30-50 % of suicides have been sorted out, many of which were due to self-harm behaviour.

Up to this point, no healthcare system has found a reliable method to register suicide attempt separately from non-suicidal self-injury. This means that figures for suicide attempts can become incorrectly high.

This Ph.D. project aims to improve the registration process in Denmark to ensure uniform and precise data. After a preliminary systematic review about definitions and rates, a qualitative approach will collect data from health care personnel to get their experiences and challenges with registration. This will provide new information and recommendation for possible improvements.

Centre for Suicide Research in Denmark already has a dedicated Register for Suicide Attempts where careful journal validation has been conducted. These data are unique and valuable. In a cohort study, it is possible to compare validated data with data from the Danish National Patient Register to look for patterns in the way validated suicide attempters use the healthcare system compared to erroneously registered suicide attempters. These patterns could hold information about missed opportunities for suicide prevention.

Description of the cohort

For the qualitative study: Health care personnel from somatic and psychiatric departments in two regions, based on a frequency analysis of registration deviations.

For the register study: People born in Denmark between 1983 and 1996 who will be followed until 2021.

Data and biological material

Data from interviews Data from the national registries

Collaborating researchers and departments

Department of Regional Health Research, University of Southern Denmark, Professor Elsebeth Stenager

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Professor Jens Laurtisen

Department of Public Health, University of Southern Denmark, Professor Pernille Tanggaard Andersen

Department of Regional Health Research, University of Southern Denmark, ph.d., lector and head of research at Centre for Suicide Research

Publications associated with the project

Jakobsen, S. G., Nielsen, T., Larsen, C. P., Andersen, P. T., Lauritsen, J., Stenager, E., & Christiansen, E. (2022, January 24,). Incidence rates of suicide attempts and self-harm in Europe: a scoping review protocol.