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The Royal College of Psychiatrists Improving the lives of people with mental illness

Oxfordshire study examines self-harm in UK armed forces

Embargoed until 02 March 2009

A study of individuals presenting to an Oxfordshire hospital suggests that an increasing number of armed forces personnel are self-harming. Their self-harm appears to be in response to relationship and employment problems – with alcohol playing a major role in most cases.

Little is known about self-harm in the armed forces. It is important to know more because self-harm, as well as indicating distress, is generally linked with risk of suicide.  However, the research found that armed forces personnel were less likely to have self-harmed before and their acts involved lower suicide intent than other self-harm patients.

Researchers investigated all armed forces personnel who attended a hospital in Oxford after self-harming between 1989 and 2003 – 166 in total. These individuals were matched with civilians who had also presented to the hospital following self-harm to provide a comparison or control group. The findings are published in the March issue of the British Journal of Psychiatry.

The number of service personnel presenting to the hospital increased substantially during the 15-year study period, with an increase of 80% between 1989-1993 and 1994-1998. There was a further 41% increase between 1994-1998 and 1999-2003.

Three-quarters of the service personnel were male. However, this is lower than the proportion of males in the Army and RAF (94.3% in 1990 and 91.4% in 2003). Therefore, the risk of self-harm in female personnel is much higher. The personnel who self-harmed were mainly young. Two-thirds were under 25-years-old. Women in particular were young, with nearly three-quarters aged between 16 and 24-years-old.

The most common method of self-harm was overdosing on painkillers, tranquillisers, sedatives or antidepressants. Self-injury, including cutting, was less common. Alcohol played a significant role in many of the cases of self-harm – particularly for the female personnel. Two-thirds of personnel had been drinking in the six hours before they self-harmed.

The armed forces personnel said they were facing a number of problems. Almost two-thirds had relationship problems with a partner. More than two-fifths (44%) said they had problems with their job, such as finding it stressful, boring or repetitive. A substantial majority (17%) wanted to leave the service, and more than one in ten were facing disciplinary problems. A quarter of personnel also said they had problems with alcohol.

The researchers found some clear differences between the armed forces group and the control group. Very few of the armed forces personnel who self-harmed had a history of psychiatric problems, compared to the control group. In addition, the service personnel were less likely to have self-harmed before and were less likely to have high suicide intent.

Writing in the British Journal of Psychiatry, the authors of the study concluded: “Self-harm by armed forces personnel may often be a response to interpersonal and employment problems complicated by alcohol misuse, with relatively low suicide intent.”

They believe strategies aimed at reducing heavy drinking within the armed forces could help to prevent cases of self-harm in future.

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