JAPAN Registry of Self-harm and Suicide Attempts: Study protocol and profile in 2022-2023

Self-harm and suicide attempts (SA) are a significant cause of emergency department visits in Japan, where over 20,000 suicides occur annually. Each suicide death is estimated to correspond to over 20 attempts, highlighting the urgent need for intervention strategies. Therefore, in 2022, the JAPAN Registry of Self-harm and Suicide Attempts (JA-RSA) was established as the first nationwide prospective registry.

This study describes the design, objectives, and initial findings of JA-RSA and evaluates its potential to inform national suicide prevention policies.

JA-RSA collects comprehensive data on patients presented to critical care centers in Japan for self-harm or SA. Between December 2022 and December 2023, data from 1987 registered cases from 44 institutions were analyzed. Patient demographics, self-harm methods, and treatment outcomes were examined and compared with national suicide statistics for 2023.

The mean age of patients was 39.3 years (36.9% male). Self-harm was inflicted through intentional drug overdose (58.2%), jumping from a height (12.1%), self-cutting (11.2%), and hanging (10.8%). Of the 1987 cases, 68.4% required intensive care treatment, 11.9% received outpatient care, and 8.3% died. Compared with national suicide statistics, JA-RSA revealed that more females and individuals aged below 20 engage in self-harm.

JA-RSA provides critical insights into the characteristics and treatment outcomes of patients who engage in self-harm. The registry's findings underscore the need for greater participation of institutions and further improvement in prevention strategies. By offering unique data, JA-RSA could help improve suicide prevention and intervention strategies.