{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T15:29:48Z","timestamp":1781969388418,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":193,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine & Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Self\u2010harm and suicide attempts (SA) are a significant cause of emergency department visits in Japan, where over 20,000 suicides occur annually. Each suicide death is estimated to correspond to over 20 attempts, highlighting the urgent need for intervention strategies. Therefore, in 2022, the JAPAN Registry of Self\u2010harm and Suicide Attempts (JA\u2010RSA) was established as the first nationwide prospective registry.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n This study describes the design, objectives, and initial findings of JA\u2010RSA and evaluates its potential to inform national suicide prevention policies.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n JA\u2010RSA collects comprehensive data on patients presented to critical care centers in Japan for self\u2010harm or SA. Between December 2022 and December 2023, data from 1987 registered cases from 44 institutions were analyzed. Patient demographics, self\u2010harm methods, and treatment outcomes were examined and compared with national suicide statistics for 2023.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The mean age of patients was 39.3\u2009years (36.9% male). Self\u2010harm was inflicted through intentional drug overdose (58.2%), jumping from a height (12.1%), self\u2010cutting (11.2%), and hanging (10.8%). Of the 1987 cases, 68.4% required intensive care treatment, 11.9% received outpatient care, and 8.3% died. Compared with national suicide statistics, JA\u2010RSA revealed that more females and individuals aged below 20 engage in self\u2010harm.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n JA\u2010RSA provides critical insights into the characteristics and treatment outcomes of patients who engage in self\u2010harm. The registry's findings underscore the need for greater participation of institutions and further improvement in prevention strategies. By offering unique data, JA\u2010RSA could help improve suicide prevention and intervention strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ams2.70081","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T06:04:36Z","timestamp":1752473076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["JAPAN<\/scp>\n Registry of Self\u2010harm and Suicide Attempts: Study protocol and profile in 2022\u20132023"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9482-944X","authenticated-orcid":false,"given":"Mayumi","family":"Hangai","sequence":"first","affiliation":[{"name":"Japan Suicide Countermeasures Promotion Center (JSCP) Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudai","family":"Iwama","sequence":"additional","affiliation":[{"name":"Japan Suicide Countermeasures Promotion Center (JSCP) Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Japan Suicide Countermeasures Promotion Center (JSCP) Tokyo Japan"},{"name":"Ota Memorial Hospital Ota City Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiharu","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Teikyo University Graduate School of Public Health Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiaki","family":"Toida","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Shinshu University Matsumoto City Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Japanese Red Cross Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Kumamoto Medical Center Kumamoto City Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasufumi","family":"Miyake","sequence":"additional","affiliation":[{"name":"Trauma and Resuscitation Center Teikyo University, School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"White Paper on Suicide Prevention (FY2024).Ministry of Health Labor and Welfare of Japan.2024. Available from:https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/hukushi_kaigo\/seikatsuhogo\/jisatsu\/jisatsuhakusyo2024.html"},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization.Preventing suicide: A global imperative.2014. Available from:https:\/\/www.who.int\/publications\/i\/item\/9789241564779"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.3.193"},{"key":"e_1_2_10_5_1","unstructured":"Ministry of Health Labor and Welfare of Japan.The General Principles of Suicide Countermeasures Policy.2022. Available from:https:\/\/www.mhlw.go.jp\/stf\/taikou_r041014.html"},{"key":"e_1_2_10_6_1","unstructured":"World Health Organization.Practice manual for establishing and maintaining surveillance systems for suicide attempts and self\u2010harm.2016. Available from:https:\/\/www.who.int\/publications\/i\/item\/practice\u2010manual\u2010for\u2010establishing\u2010and\u2010maintaining\u2010surveillance\u2010systems\u2010for\u2010suicide\u2010attempts\u2010and\u2010self\u2010harm"},{"key":"e_1_2_10_7_1","unstructured":"National Self\u2010harm Registry Ireland: Annual Report 2021: National Suicide Research Foundation.2024. Available from:https:\/\/www.nsrf.ie\/wp\u2010content\/uploads\/2024\/02\/NSRF\u2010National\u2010Self\u2010Harm\u2010Registry\u2010Ireland\u2010annual\u2010report\u20102021.pdf"},{"key":"e_1_2_10_8_1","first-page":"39","article-title":"Support for suicide attempts and development of strategies to prevent suicide attempts in emergency centers","volume":"13","author":"Kawanishi C","year":"2008","journal-title":"Trends Sci"},{"key":"e_1_2_10_9_1","first-page":"247","article-title":"Characteristics of suicides according to prehospital records in Kishiwada City, Osaka prefecture","volume":"55","author":"Toyoda Y","year":"2008","journal-title":"Jpn J Public Health"},{"key":"e_1_2_10_10_1","unstructured":"Project Website: JAPAN Registry of Self\u2010harm and Suicide Attempts. Available from:https:\/\/ja\u2010rsa.net\/"},{"key":"e_1_2_10_11_1","unstructured":"Website: Japanese Society for Emergency Medicine (JSEM).2008. Available from:https:\/\/jsem.me\/english.html"},{"key":"e_1_2_10_12_1","unstructured":"Website: Japan Suicide Countermeasures Promotion Center (JSCP).2024. Available from:https:\/\/jscp.or.jp\/english\/"},{"key":"e_1_2_10_13_1","unstructured":"JAPAN Registry of Self\u2010harm and Suicide Attempts (JA\u2010RSA): Annual Report 2024: JA\u2010RSA Project Team.2024. Available from:https:\/\/sites.google.com\/jscp.or.jp\/jarsa\/%E5%A0%B1%E5%91%8A%E6%9B%B8"},{"key":"e_1_2_10_14_1","unstructured":"Website: Number of suicides based on suicide statistics: Ministry of Health Labor and Welfare of Japan.2024. Available from:https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/hukushi_kaigo\/seikatsuhogo\/jisatsu\/jisatsutoukei\u2010jisatsusyasu.html"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/appy.12216"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20200018"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-4458-8-43"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1996.tb10656.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2023.01.007"}],"container-title":["Acute Medicine & Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.70081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T07:46:12Z","timestamp":1766475972000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ams2.70081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/ams2.70081"],"URL":"https:\/\/doi.org\/10.1002\/ams2.70081","archive":["Portico"],"relation":{},"ISSN":["2052-8817","2052-8817"],"issn-type":[{"value":"2052-8817","type":"print"},{"value":"2052-8817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-12-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70081"}}