Self-Harm in Older People and the Potential Effects of Covid-19 on Rates of Self-Harm and Suicide
Self-harm is an enormous clinical and public health concern, which is both upsetting on a societal level and can also clearly have a devastating impact on the individual, family members, friends. It impacts on a health, work, educational and social care level.
It is worryingly prevalent and throughout many areas of the world it is an increasing trend. Although we know that self-harm rates are lower among older people compared to rates in teenagers, children and younger adults, suicide completion rates in older adults are significantly higher. We also know that if you regularly self-harm there is a far higher chance of individuals completing a suicide.
Self-Harm Risk Factors in Older People
Risk factors in this age group include:
- Co-morbid physical health problems
- A perceived loss of control
- Increased isolation, both actual and perceived
- Belief with some, that they may be burdensome
Older people are more likely to regularly repeat self-harm if they have a history of harming behaviours and/or a history of receiving psychiatric treatment. Therefore, we are in a position to be able to predict those that are potentially at risk and offer, if available, support.
That said attempted suicide and self-harm in older people, particularly when it occurs for the first time in old age, should result in a referral to mental health services or some form of specialist care as soon as possible, as statistics show that there is a greater chance of completed suicide within a year.
How Do Self-Harming Behaviours Differ Between Older and Younger People?
The methods and frequency of use of these methods, used by different generations to perform the self-harm does differ. In younger people common methods of self-harm include:
- Overdoses (self-poisoning)
- Cutting (self-mutilation)
- Burning and scalding
- Banging heads/ punching against walls
In older people self-poisoning or over-dose were the most commonly reported method. Other more common methods in older people include:
- Refusing to eat
- Hitting self
- Carbon monoxide poisoning
Some studies have shown that up to 81% of self-harming behaviours involves poisoning in older people. That said, the research into this group is scant and much of the research that has taken place has happened with comparatively small groups and over relatively short periods of time.
Will the Impact of Covid-19 Worsen Self Harm in Older People?
So in our current situation as we come out of lockdown and remain to social distance, and where physical isolation is encouraged, there is an enhanced need to rely on new technologies to see friends and maintain some contact. Older people are likely to have heightened anxiety levels in relation to the disease itself, concerns about their own mortality and the impact on personal finances. They may also be worried about needing to ask others for support (perhaps then feeling burdensome).
Sadly, there is a greater risk of the older generation self-harming. Other risk factors include single marital status, living alone, being aged between 60 and 74 years old and having a history of alcohol or drug misuse.
Clearly age is not the only determiner in the prevalence of self-harm. This is a hugely complex subject and relatively little research has gone into this subject. However, with the current situation that the UK and indeed many parts of the world find themselves in, then predictors, such as social isolation should be highlighted and treated as a potential indicator of significant risk.
Self-Harm and Suicide
We too commonly perceive self-harm as an issue affecting young people (Townsend, 2014) and studies have frequently focussed on this age-group. However, as said earlier; rates of suicide are actually among the highest in the elderly (World Health Organization, 2014), and self-harm is a major risk factor for suicide completion.
How We Can Support Older People Who Self-Harm
What we do know is that care and compassion have a huge role to play in supporting those that harm to recover/ manage their harming ways well.
In times of enormous change to our daily lives, high anxiety and fear, loss, bereavement and financial hardship, our ability to care does not need to be compromised, in fact it could be enhanced, just by making contact, supporting others and helping out wherever we can.
Written by Jackie Shanks