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New paper out today looking at how rates of hospital of admission for self-harm vary by ethnicity in London https://doi.org/10.1007/s00127-021-02087-9 with @HatchStephani @MatthewHotopf & @IoannisBakolis 1/
Rates of self-harm by ethnicity are difficult to study in the UK. Surveys very rarely have large enough samples of minority groups to look at differences between them. Most studies use service-use data but even then heterogenous groups tend to be collapsed together. 2/
We used routinely collected data on who was admitted to general hospitals for physical health treatment for self-harm. The large dataset meant we could split ethnicity into 16 categories. We also adjusted for deprivation, which we know increases self-harm risk. 3/
We found lower rates of self-harm admission at all ages in both sexes for all the Black and Asian ethnicities when compared to the White British population. Adjustment for deprivation increased these differences. 4/
Rates of self-harm by age also differed. Overall rates were highest in under 25 as expected, but in men from Black and Mixed ethnicities rates peaked aged 25-44. 5/
There were big differences within the broader White category: White Irish people had the highest rates of first and repeat admission, the White other group much lower rates than the White British group. 6/
So, rates in almost all minoritised ethnicities appear low, with patterns not related to deprivation. This is despite greater exposure to socio-economic stressors which we know usually increase self-harm risk. What's going on here? 7/
Risk factors for self-harm identified in White populations may not be good predictors in other groups. Other aspects of communities not captured by area deprivation measures may be protective. Self-harm may be a less acceptable response to stressors. 8/
However, similar patterns across such heterogenous groups means we should be cautious locating explanations in specific cultures. The common experience amongst these groups is a position of structural disadvantage as a minority within the UK. 9/
Our previous work explored how marginalisation impacts on how people feel able to express distress and the likelihood of their accessing help https://journals.sagepub.com/doi/10.1177/1049732320957628. Narrow clinical definitions of what behaviours count as self-harm, & using hospital data make this important. 10/
