Increase in deliberate self-harm seen by helicopter emergency service during pandemic

7th October 2021

Self-harm incidents seen by the helicopter emergency medical services increased significantly during the first-wave of the COVID-19 pandemic.

As well as the physical health concerns raised during the COVID-19 pandemic, there has also been a recognised impact upon individual’s mental health due to several factors including social isolation, anxieties over contracting the virus and economic hardship. Although helicopter medical services (HEMS) are designed to attend to seriously ill and injured patients within the community, an analysis of the attendance of HEMS before and during the first wave of the COVID-19 pandemic, could be used to provide a measure of the mental health and well being of the population. This was the overall aim of a study undertaken in the East of England by researchers from the Department of Research, Audit, Innovation and Development, East Anglian Air Ambulance, UK. The researchers undertook a comparative, retrospective analysis of deliberate self-harm (DSH) incidents over two 61 day periods; March to 30 April 2019 (the control period) and between the same period in 2020 (COVID-19). The researchers looked at the overall activity of the HEMS during the two periods of time as well as the number of self-harm incidents. A self-harm incident was defined as “any act or self-poisoning or self-injury”, and severe self-harm as cardiac arrest and or death prehospital. The primary aim was to compare the incidence of deliberate self-harm incidents (DSH-I) before and during the first wave of the COVID-19 pandemic.

Findings

There were a total of 1725 HEMS activations; 981 during the control period and 744 during the COVID-19 period, which represented a 24.2% reduction in overall activity. However, during the COVID-19 period, there was an 11% increase in the number of DSH activations (73 vs 81, control vs COVID-19). For the primary outcome measure, there was a 65.4% increase in DSH-I encounters during the COVID-19 period compared with the control period. In fact, DSH-I encounters represented 9.5% of all activity during COVID-19 compared to 4.5% during the control period (odds ratio, OR = 2.3, 95% CI 1.40 – 3.7, p = 0.002). The increase was mainly due to hanging (17 vs 6, COVID-19 vs control) and falls from height (10 vs 3) although these differences were not statistically different.

The authors concluded that although the overall level of HEMS activity was lower during the COVID-19 period, the pandemic appeared to result in a nearly two-thirds increase (65%) in the number of DSH-I.

Citation

Stevens J et al. Comparison of deliberate self-harm incidents attended by Helicopter Emergency Medical Services before and during the first wave of COVID-19 in the East of England. BMJ 2021