Self-harm in older adults a strong suicide predictor

OLDER adults who self-harm are at exponentially increased risk of suicide, a British study has found.

Compared with the general population, suicide risk was 67 times higher among older adults who had presented to hospital with self-harm in the previous year. Men over 75 were at greatest risk.

The authors of an accompanying editorial said the findings, which were based on more than 1100 people who attended hospital due to non-fatal self-harm, demonstrated the need for follow up by people with appropriate training.
Dr Roderick McKay, chair of the Royal Australian and New Zealand College of Psychiatry’s faculty of psychiatry of old age, echoed those points.

“There tends to be an underestimation of risk in older people, but there are very real costs,” he said. Adequate follow-up was essential, but many mental health professionals and doctors lacked training specific to older adults, Dr McKay said. 

Research has shown a significant proportion of older adults who commit suicide had visited a GP in the lead-up, and while a mental health problem was commonly identified, assessment of suicide risk was often not undertaken, or in other cases the assessment did not reveal suicide ideation, and no further follow up occurred.

“We have to take any incident of self-harm very seriously, even if it’s an apparently minor attempt – there needs to be further assessment,” he said.

“And plan to reassess,” he added. 

Br J Psych 2012; 200:399-404