And people from Black and minority ethnic groups are less likely to receive specialist psychiatric assessment and access to follow-up services after an episode of self-harm than people from the White population. Researchers from the universities of Manchester and Oxford, who carried out the research, are calling for self-harm services to become more “culturally sensitive”.
The researchers studied 14,997 people who attended emergency departments in three cities – Derby, Oxford and Manchester – having self-harmed. They found that rates of self-harm in young Black women were highest in all three cities. For example, the rate of self-harm among young Black women is Manchester was 10.3 per 1000 people, compared to 6.6 per 1000 in the White population.
In contrast, rates of self-harm in young Black men in the three cities did not differ significantly from those in young White men. There were lower rates of self-harm in older Black people of both genders compared to White people.
The researchers also found that young Black women were slightly less likely to receive a specialist psychiatric assessment after self-harming than White women. Furthermore, men and women from both Black and minority ethnic groups were less likely to re-attend at hospital with further episodes of self-harm.
Dr Jayne Cooper, of the Centre for Suicide Prevention at the University of Manchester and lead author of the research, said: “To our knowledge, this is the first study to show significantly higher rates of self-harm in young Black females across a number of cities using large population-based databases. We cannot be certain why this is, but it’s possible that young Black women who self-harm are experiencing more social problems. For example, in our study young black women were more likely to be unemployed and report housing problems than White women. We also found that people from ethnic minority groups who self-harmed were more likely to be students than their White counterparts, and so may be under academic pressure.”
Dr Cooper continued: “Despite the increased risk of self-harm in young Black females, we found that fewer receive psychiatric care. One explanation is that they are seen as being at ‘low risk’ clinically of self-harming again – because they are less likely to live alone, less likely to have used alcohol during the self-harm attempt, and less likely to have a previous history of self-harm. They may also not communicate their distress to clinical staff as much, and be less likely to admit to depression. It has also been suggested that Black and minority ethnic groups may find themselves disillusioned with the services they receive, and so be reluctant to return to hospital if they self-harm again.”
Dr Cooper concluded: “Our findings have important implications for how we design services for people who self-harm. The challenge is to make services more culturally sensitive, and ensure that everyone receives assessment and appropriate management following self-harm.”
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Cooper J, Murphy E, Webb R, Hawton K, Bergen H, Waters K and Kapur N (2010) Ethnic differences in self-harm, rates, characteristics and service provision: three-city cohort study, British Journal of Psychiatry, 197: 212-218.