Risk Factors for Self-Inflicted Injury Inform Prevention and Treatment in Orange County

Self-inflicted injury remains both a serious mental and public health issue. There are negative consequences to the individual, members of that family, and friends, and the community. There is also a significant burden to society.  In 2006, an estimated 594,000 emergency department visits across the United States were the direct result of a self-inflicted injury. The cost of self-inflicted injury is direct in terms of dollars spent on care and indirect with lost productivity. The economic impact to society is estimated to be around $33 billion annually. Intentional self-harm can also be strong predictor of future suicidal behavior.

This study examined both emergency department and hospitalization data for Orange County residents between 2009 and 2011. During this period, there were nearly 9,000 incidents of intentional self-harm injury, which equated to nearly 2,800 cases each year. The majority of those cases were from poisoning/overdose (65%), followed by cutting or piercing (24%). Of those admitted, nearly 80% (n=3,574 of 4,516) were diagnosed to have a mental illness, and 9.3% of all self-harm incidents were lethal (n=835). Those most at risk of self-harm included females, young adults 18 to 24 years of age, followed by adolescents 10 to 17 years old. Compared to other racial/ethnic groups, non-Hispanic whites tended to have the highest number of incidents and rates across nearly all age groups.

This study will help guide the Health Care Agency’s Prevention and Early Intervention programs, which are funded through the Mental Health Services Act, to better identify and treat those most at risk for self-harm behavior.