Self-harm hospitalizes 17,000 a year: report

More than 45 Canadians are hospitalized every day due to self-injury and many of those are 15 to 19 years old, according to a new report.

The Canadian Institute for Health Information released the report on measuring mental health services on Wednesday.

It showed that in  2009–2010, about 140 Canadians per 100,000 were cared for in an emergency department, admitted to a general hospital or died from self-inflicted injuries, compared with 124 per 100,000 hospitalized because of a stroke. "Mental health–related indicators tell us not just about the use of general hospital services, but about broader access to care and support across the system," said Chantal Couris, senior researcher of health system performance at CIHI.

"Readmission rates, for example, are measures of the coordination and continuity of mental health services. Not all readmissions can be avoided, but ensuring that community services are available for people after they leave the hospital may help prevent the so-called revolving door of hospitalization for those living with a mental illness."

About 41 per cent of mental health readmissions occurred within seven days, and almost two-thirds, 64 per cent, took place within 14 days of discharge.

Readmission was more likely when the initial hospitalization was for schizophrenia (13.2 per cent) or a personality disorder (13.1 per cent) than when it was for an anxiety disorder (8.9 per cent).

Finding help outside of hospital

Kym Boulay, 29, of Winnipeg recalls how she deliberately burned herself. Apart from a hospital, there weren't any places to go for help, and she tried to kill herself 15 times from the age of 15 to 24.

"I felt numb a lot of times, and I just needed a place to feel pain," said Boulay,  who now spends most of her time counselling at a mood disorders centre to use her painful experience to try to help others escape the destructive cycle of self-abuse.

The report also shows a need for more community-based services, said chief psychiatrist Dr. Marshall Korenblum at the Hincks-Dellcrest Centre in Toronto.

"What this report shows is that there is terrible integration between admission and post-admission care," said Korenblum. "So, yes, referral to after care support services, community-based services."

At Korenblum's clinic, it takes children and youth up to a year to see a psychiatrist.

"For a teenager whose self esteem is already kind of fragile, their reputation, if you will, can be ruined in a matter of seconds. And then what you do is you get shame and humiliation and then that can be one of the reasons for desire to self harm," Korenblum said.

To help bridge the gap in need, Korenblum suggested:

• Offering more counselling at a professional's office.
• Introducing more home-based services by child and youth workers.
• Teaming up psychiatrists with family doctors.
• Using technologies such as counselling over webcam.

The study found that poisoning was involved in 85 per cent of the self-injuries that led to hospitalization, and nine out of 10 of these were attributed to prescription or non-prescription medications.

Cutting or piercing accounted for 10 per cent, and two per cent were strangulations.

What the report's authors did not look at was children under the age of 15, or admissions to hospitals other than general hospitals, such as psychiatric institutions, Korenblum said.

Canada is the only industrialized country that has no national strategy on suicide and no way to co-ordinate the fragmented suicide prevention services that do exist, said Tim Wall, executive director for the Canadian Association for Suicide Prevention in Winnipeg.