New global study identifies factors behind why older people self-harm

A new study led by Keele University has found that older people who self-harm may do so because of social factors including isolation, loneliness, poor housing and financial hardship.

The research, published in the British Journal of Psychiatry, found several characteristics that were key factors, including mental health conditions, alcohol and substance misuse, as well as physical illnesses such as cardiovascular disease, diabetes, and musculoskeletal disorders. Societal issues were also identified as an influencing factor including poor housing, environment, financial hardship, low standard of education, and social isolation.

A previous study from Keele University, which analysed UK primary care data, has already found that people over 65 who self-harm are 20 times more likely to die an unnatural death and 145 times more likely to die by suicide than people of the same age who had not self-harmed.  

The research, published in the British Journal of Psychiatry, analysed 40 global studies on 62,755 older adults who had self-harmed and was led by Isabela Troya Bermeo, from Keele University’s Research Institute for Primary Care and Health Sciences. Troya Bermeo commented: “This study assessed global evidence and identified several contributing factors towards why older people self-harm. We found similar results in relation to the risk of death as the previous Keele study, but interestingly this new research identified several societal influencing factors such as loneliness and isolation, their environment, and financial hardship. Those older adults with health conditions (both physical and mental illness) were also found to be at increased risk of self-harm.

“It is important to highlight that self-harm is not just a problem for young people, as these older adults need to be treated and managed differently to younger populations because of their different characteristics, including higher suicide risk, and due to their more frequent contact with health services, doctors have the opportunity of identifying self-harm in the consultation room and offer treatment and management.

“It is important that clinicians prescribing antidepressants, amongst other medication, are aware of the characteristics and increased risk of self-harm in this population and ensure adequate follow-up is in place.”

Co-author Professor Carolyn Chew-Graham, GP and Professor of General Practice Research at Keele University’s Research Institute for Primary Care and Health Sciences, said: “The study highlights the potential role for primary care clinicians in identifying and supporting older adults with self-harm, as these people will be consulting for comorbid physical conditions. Intervention offers the potential to prevent suicide. In addition, this paper has an important message for GPs like myself, to always be careful in prescribing for older adults where there may be a risk of self-harm. The link with loneliness and social isolation is an important message about thinking more broadly of social interventions.”