Self-harm and attempted suicide among therapeutic community admissions

The study aimed to determine the histories of self-harm and attempted suicide among therapeutic community entrants by primary presenting substance problem, and to determine predictors of these behaviours.

One hundred and eighty-eight consecutive new treatment admissions to We Help Ourselves drug-free treatment services were administered a structured interview.

Lifetime histories of self-harm were reported by 34% (9% within the preceding year), and 20% had done so on multiple occasions. Just over one-third reported a lifetime history of attempted suicide (15% within the preceding year), and 17% reported multiple attempts. There were no significant bivariate associations between primary drug and either behaviour. Multivariate analyses indicated that the alcohol and opioid groups were significantly more likely than the cannabis group to have a history of self-harm, but did not differ from each other or the psychostimulant group. Other independent correlates of self-harm were female gender, lifetime PTSD diagnosis, younger age at first intoxication and a history of attempted suicide. In multivariate analyses, the alcohol and opioid groups were significantly less likely than the cannabis group to have a history of attempted suicide, but did not differ from each other or the psychostimulant group. Other significant correlates of attempted suicide were female gender and a history of self-harm.

Both self-harm and suicide attempts were highly prevalent, and strongly associated with each other. Moreover, there were few differences between primary drug problems. All entrants should be screened for these behaviours, and appropriate responses implemented.