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Repeat self-harm hospitalizations in Canada: a survival analysis
Li Liu1, Gisèle Contreras2, Wendy Thompson2
1Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada. Li.Liu@phac-aspc.gc.ca.
Injury Epidemiology
|May 9, 2025
Summary
Approximately 1 in 10 patients hospitalized for self-harm in Canada are readmitted within three years, with most readmissions occurring in the first year. Females, young individuals, and those with mental disorders face higher readmission risks, highlighting the need for targeted interventions.
Area of Science:
- Public Health
- Psychiatry
- Epidemiology
Background:
- Repeat self-harm hospitalizations pose significant suicide risks and healthcare burdens.
- Canadian research has primarily focused on self-harm prevalence, neglecting repeat admission patterns.
- This study addresses the gap by assessing repeat self-harm hospitalization risk in Canada.
Purpose of the Study:
- To determine the risk of repeat self-harm hospitalizations in Canada.
- To identify specific population subgroups at elevated risk for readmission.
- To inform targeted interventions and resource allocation for self-harm prevention.
Main Methods:
- Analysis of 74,055 patients hospitalized for self-harm between April 2016 and March 2022.
- Utilized Canadian Institute for Health Information and Ontario Mental Health Reporting System data.
- Employed Kaplan-Meier survival analysis and Cox regression models to assess readmission risk and associated factors.
Main Results:
- The risk of readmission was 9.3% within one year and 13.0% within three years.
- Three-quarters of readmissions occurred within the first year, 90% within two years.
- Females (HR=1.32), particularly aged 10-14 (19.2% within three years), and individuals with mental disorders or specific self-harm methods (cutting, substance poisoning) showed higher readmission risks.
Conclusions:
- About 10% of self-harm hospitalizations in Canada result in readmission, predominantly within the first year.
- Females, young individuals, those using specific self-harm methods, and individuals with mental disorders are at higher risk.
- Findings underscore the need for targeted interventions, improved mental health support, and strategic resource allocation to prevent self-harm recurrence.
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