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The impact of the COVID-19 pandemic on health service utilisation following self-harm: a systematic review
Sarah Steeg
Ann John
David Gunnell
Nav Kapur
Dana Dekel
Lena Schmidt
Duleeka Knipe
Ella Arensman
Keith Hawton
Julian Higgins
Emily Eyles
Catherine Macleod Hall
Luke A McGuinness
Roger T. Webb
Acceso Abierto
Atribución-SinDerivadas
https://doi.org/10.1101/2022.01.26.22269901
https://www.medrxiv.org/content/10.1101/2022.01.26.22269901v1
Background Evidence on the impacts of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020. Aims To systematically review evidence on health services utilisation for self-harm during the COVID-19 pandemic. Methods A comprehensive search of multiple databases (WHO COVID-19 database, Medline, medRxiv, Scopus, PsyRxiv, SocArXiv, bioRxiv, COVID-19 Open Research Dataset, PubMed) was conducted. Studies reporting presentation frequencies for self-harm published from 1st Jan. 2020 to 7th Sept. 2021 were included. Study quality was assessed using a critical appraisal tool. Results Fifty-one studies were included. 59% (30/51) were rated as low quality, 29% (15/51) as moderate and 12% (6/51) as high-moderate. Most evidence (84%, 43/51 studies) was from high-income countries. 47% (24/51) of studies reported reductions in presentation frequency, including all 6 rated as high-moderate quality, which reported reductions of 17-56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the 3 higher quality studies including study observation months from 2021 reported reductions in service utilisation. Evidence from 2021 suggested increased use of health services following self-harm among adolescents, particularly girls. Conclusions Sustained reductions in service utilisation were seen into the first half of 2021. However, evidence from low- and middle-income countries is lacking. The increased use of health services among adolescents, particularly girls, into 2021 is of concern. Our findings may reflect changes in thresholds for help seeking, use of alternative sources of support and variable effects of the pandemic across different groups.
medRxiv and bioRxiv
28-01-2022
Preimpreso
https://www.medrxiv.org
Inglés
Epidemia COVID-19
Público en general
VIRUS RESPIRATORIOS
Versión publicada
publishedVersion - Versión publicada
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