Dedicated Registries for Hospital-Presented Suicide Attempts and Self-Harm

    Dedicated registries focus solely on the collection of data related to hospital-presented suicide attempts and self-harm. Data collectors are recruited and trained for the purpose of obtaining data on consecutive hospital presentations resulting from attempted suicide and self-harm. Surveillance is conducted on the full population for a specific geographical area or a whole country.
    The advantage of a dedicated registry is that service provision, resource deployment and guidelines/protocols for self-harm management are very specific to that area. Real-time data can be gathered and used to guide service delivery, particularly the assessment and management of hospital-presented suicide attempts and self-harm.

    The National Self-Harm Registry Ireland is currently the only registry at national level covering consecutive cases of self-harm (including suicide attempts) presenting to all general hospitals in the country (2,3). However, at subnational level, the Self-Harm Registry in Northern Ireland, which was developed on the basis of the registry in Ireland, and the Registry of Suicide Attempts in Flanders, Belgium, cover all hospital-presented suicide attempts and self-harm acts in their respective regions (4).

    The longest established registry is the Oxford Monitoring System of Deliberate Self-harm, which was established in 1976 and collects all information on self-harm (including suicide attempt) cases presenting to John Radcliffe Hospital, Oxford, United Kingdom. It is unique in Europe in terms of the completeness of data obtained and its duration. Based on Oxford’s longstanding experience and in order to serve as a resource for others intending to set up a self-harm surveillance system, the procedures used for monitoring, case definition and identification, investigation of repetition, data protection and ethical issues have been outlined (5).

    The Oxford monitoring system provided the template for the United Kingdom’s Multicenter Monitoring System of Deliberate Self-Harm which was established in 2000 and covers consecutive hospital presentations of self-harm in the cities of Derby, Manchester and Oxford (5). The registries are fairly consistent with regard to definition of the target behavior, inclusion criteria, standard operating procedures and provision of training for officers and researchers involved in data collection. Findings from these registries suggest a correlation of figures with prevention initiatives and an influence of the registries on national strategies and legislation.