{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T23:37:38Z","timestamp":1775950658284,"version":"3.50.1"},"reference-count":60,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: The incidence of hospital-presenting self-harm peaks among young people, who most often engage in intentional drug overdose (IDO). The risk of self-harm repetition is high among young people and switching methods between self-harm episodes is common. However, little is known about their patterns of repetition and switching following IDO. This study aimed to investigate repeat self-harm and method-switching following hospital-presenting IDO among young people. Methods: Data from the National Self-Harm Registry Ireland on hospital-presenting self-harm by individuals aged 10\u201324 years during 2009\u20132018 were examined. Cox proportional hazards regression models with associated hazard ratios (HRs), survival curves and Poisson regression models with risk ratios (RRs), were used to examine risk factors for repetition and method-switching. Results: During 2009\u20132018, 16,800 young people presented following IDO. Within 12 months, 2136 young people repeated self-harm. Factors associated with repetition included being male (HR = 1.13, 95% CI: 1.03\u20131.24), aged 10\u201317 years (HR = 1.29, 95% CI: 1.18\u20131.41), consuming \u2265 50 tablets (HR = 1.27, 95% CI: 1.07\u20131.49) and taking benzodiazepines (HR = 1.67, 95% CI: 1.40\u20131.98) or antidepressants (HR = 1.36, 95% CI: 1.18\u20131.56). The cumulative risk for switching method was 2.4% (95% CI: 2.2\u20132.7). Method-switching was most likely to occur for males (RR = 1.36; 95% CI: 1.09\u20131.69) and for those who took illegal drugs (RR = 1.63; 95% CI: 1.19\u20132.25). Conclusion: Young males are at increased risk of repeat self-harm and method-switching following IDO and the type and quantity of drugs taken are further indicators of risk. Interventions targeting IDO among young people are needed that ensure that mental health assessments are undertaken and which address access to drugs.<\/jats:p>","DOI":"10.3390\/ijerph17176159","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T09:30:07Z","timestamp":1598347807000},"page":"6159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Repeat Self-Harm Following Hospital-Presenting Intentional Drug Overdose among Young People\u2014A National Registry Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5994-3279","authenticated-orcid":false,"given":"Caroline","family":"Daly","sequence":"first","affiliation":[{"name":"National Suicide Research Foundation, Cork 021, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eve","family":"Griffin","sequence":"additional","affiliation":[{"name":"National Suicide Research Foundation, Cork 021, Ireland"},{"name":"School of Public Health, University College Cork, Cork 021, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine","family":"McMahon","sequence":"additional","affiliation":[{"name":"National Suicide Research Foundation, Cork 021, Ireland"},{"name":"School of Public Health, University College Cork, Cork 021, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1201-7136","authenticated-orcid":false,"given":"Paul","family":"Corcoran","sequence":"additional","affiliation":[{"name":"National Suicide Research Foundation, Cork 021, Ireland"},{"name":"School of Public Health, University College Cork, Cork 021, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8532-2647","authenticated-orcid":false,"given":"Roger T.","family":"Webb","sequence":"additional","affiliation":[{"name":"NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13, UK"},{"name":"Division of Psychology &amp; Mental Health, Centre for Mental Health and Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1489-4573","authenticated-orcid":false,"given":"Katrina","family":"Witt","sequence":"additional","affiliation":[{"name":"Orygen, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darren M.","family":"Ashcroft","sequence":"additional","affiliation":[{"name":"NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13, UK"},{"name":"Division of Pharmacy &amp; Optometry, Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ella","family":"Arensman","sequence":"additional","affiliation":[{"name":"National Suicide Research Foundation, Cork 021, Ireland"},{"name":"School of Public Health, University College Cork, Cork 021, Ireland"},{"name":"Australian Institute for Suicide Research and Prevention, Griffith University, Queensland 4122, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"ref_1","unstructured":"Griffin, E., McTernan, N., Wrigley, C., Nicholson, S., Arensman, E., and Williamson, E. (2019). National Self-Harm Registry Ireland Annual Report 2018, National Suicide Research Foundation. Available online: https:\/\/www.nsrf.ie\/wp-content\/uploads\/2019\/10\/NSRF-National-Self-Harm-Registry-Ireland-Annual-Report-2018-for-website.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1192\/bjp.bp.113.130179","article-title":"Non-fatal repetition of self-harm in Taipei City, Taiwan: Cohort study","volume":"204","author":"Kwok","year":"2014","journal-title":"Br. J. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s00127-018-1522-1","article-title":"Increasing rates of self-harm among children, adolescents and young adults: A 10-year national registry study 2007\u20132016","volume":"53","author":"Griffin","year":"2018","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"343","DOI":"10.5694\/mja17.00434","article-title":"Paediatric mental and physical health presentations to emergency departments, Victoria, 2008\u20132015","volume":"208","author":"Hiscock","year":"2018","journal-title":"Med. J. Aust."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"j4351","DOI":"10.1136\/bmj.j4351","article-title":"Incidence, clinical management, and mortality risk following self harm among children and adolescents: Cohort study in primary care","volume":"359","author":"Morgan","year":"2017","journal-title":"BMJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1080\/15563650.2019.1687900","article-title":"Trends of intentional drug overdose among youth: A population-based cohort study","volume":"58","author":"Gilley","year":"2020","journal-title":"Clin. Toxicol. Phila."},{"key":"ref_7","first-page":"e1","article-title":"Differing patterns in intentional and unintentional poisonings among young people in England, 1998\u20132014: A population-based cohort study","volume":"39","author":"Tyrrell","year":"2017","journal-title":"J. Public Health Oxf."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e026001","DOI":"10.1136\/bmjopen-2018-026001","article-title":"Trends in self-poisoning and psychotropic drug use in people aged 5\u201319 years: A population-based retrospective cohort study in Australia","volume":"9","author":"Cairns","year":"2019","journal-title":"BMJ Open"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s00787-012-0269-6","article-title":"Epidemiology and nature of self-harm in children and adolescents: Findings from the multicentre study of self-harm in England","volume":"21","author":"Hawton","year":"2012","journal-title":"Eur. Child. Adolesc. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S2352-4642(19)30373-6","article-title":"Mortality in children and adolescents following presentation to hospital after non-fatal self-harm in the Multicentre Study of Self-harm: A prospective observational cohort study","volume":"4","author":"Hawton","year":"2020","journal-title":"Lancet Child. Adolesc. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/j.1469-7610.2007.01852.x","article-title":"Deliberate self-harm by under-15-year-olds: Characteristics, trends and outcome","volume":"49","author":"Hawton","year":"2008","journal-title":"J. Child. Psychol. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bennardi, M., McMahon, E., Corcoran, P., Griffin, E., and Arensman, E. (2016). Risk of repeated self-harm and associated factors in children, adolescents and young adults. BMC Psychiatry, 16.","DOI":"10.1186\/s12888-016-1120-2"},{"key":"ref_13","first-page":"681","article-title":"Frequently used drug types and alcohol involvement in intentional drug overdoses in Ireland: A national registry study","volume":"28","author":"Daly","year":"2018","journal-title":"Eur. J. Public Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1080\/15563650.2016.1177187","article-title":"Repetition of intentional drug overdose: A population-based study","volume":"54","author":"Finkelstein","year":"2016","journal-title":"Clin. Toxicol. Phila."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jad.2016.10.014","article-title":"Age-related differences in self-harm presentations and subsequent management of adolescents and young adults at the emergency department","volume":"208","author":"Diggins","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1192\/bjp.bp.110.080952","article-title":"Mortality and suicide after self-harm: Community cohort study in Taiwan","volume":"198","author":"Chen","year":"2011","journal-title":"Br. J. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Perry, I.J., Corcoran, P., Fitzgerald, A.P., Keeley, H.S., Reulbach, U., and Arensman, E. (2012). The incidence and repetition of hospital-treated deliberate self harm: Findings from the world\u2019s first national registry. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0031663"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.jad.2018.10.372","article-title":"Method of self-harm and risk of self-harm repetition: Findings from a national self-harm registry","volume":"246","author":"Cully","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Martin, C.A., Chapman, R., Rahman, A., and Graudins, A. (2014). A retrospective descriptive study of the characteristics of deliberate self-poisoning patients with single or repeat presentations to an Australian emergency medicine network in a one year period. BMC Emerg. Med., 14.","DOI":"10.1186\/1471-227X-14-21"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.annemergmed.2006.07.944","article-title":"A clinical tool for assessing risk after self-harm","volume":"48","author":"Cooper","year":"2006","journal-title":"Ann. Emerg. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1136\/emj.15.4.257","article-title":"Recurrent overdose: Patient characteristics, habits, and outcomes","volume":"15","author":"Taylor","year":"1998","journal-title":"J. Accid. Emerg. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"616","DOI":"10.2105\/AJPH.64.6.616","article-title":"Psychopharmacological roulette: A follow-up study of patients hospitalized for drug overdose","volume":"64","author":"Mayo","year":"1974","journal-title":"Am. J. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.jad.2018.11.001","article-title":"Patterns of self-harm methods over time and the association with methods used at repeat episodes of non-fatal self-harm and suicide: A systematic review","volume":"245","author":"Witt","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.jad.2015.03.051","article-title":"Switching methods of self-harm at repeat episodes: Findings from a multicentre cohort study","volume":"180","author":"Owens","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref_25","first-page":"711","article-title":"Methods of suicide predict the risks and method-switching of subsequent suicide attempts: A community cohort study in Taiwan","volume":"10","author":"Huang","year":"2014","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/0004867414553951","article-title":"Switching suicide methods as a predictor of completed suicide in individuals with repeated self-harm: A community cohort study in northern Taiwan","volume":"49","author":"Wang","year":"2015","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_27","first-page":"205","article-title":"Stability in the choice of method during the period preceding a suicide attempt and in attempt repeaters","volume":"30","author":"Deisenhammer","year":"2016","journal-title":"Eur. J. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1600-0447.1992.tb01451.x","article-title":"Parasuicide in Europe: The WHO\/EURO multicentre study on parasuicide. I. Introduction and preliminary analysis for 1989","volume":"85","author":"Platt","year":"1992","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.2105\/AJPH.2013.301326","article-title":"Method choice in nonfatal self-harm as a predictor of subsequent episodes of self-harm and suicide: Implications for clinical practice","volume":"103","author":"Miller","year":"2013","journal-title":"Am. J. Public Health"},{"key":"ref_30","unstructured":"World Health Organization (2020, June 19). Collaborating Centre for Drug Statistics Methodology, Guidelines for ATC Classification and DDD Assignment. Available online: https:\/\/www.whocc.no\/atc_ddd_index_and_guidelines\/atc_ddd_index\/."},{"key":"ref_31","unstructured":"(2020, June 19). Misuse of Drugs Act. Available online: http:\/\/www.irishstatutebook.ie\/eli\/1984\/act\/18\/enacted\/en\/html."},{"key":"ref_32","unstructured":"(2020, June 19). Misuse of Drugs Act. Available online: http:\/\/www.irishstatutebook.ie\/eli\/1977\/act\/12\/enacted\/en\/html."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Larkin, C., di Blasi, Z., and Arensman, E. (2014). Risk factors for repetition of self-harm: A systematic review of prospective hospital-based studies. PLoS ONE, 9.","DOI":"10.1371\/annotation\/b3dfd1b3-ada1-4f7e-89d4-a25ddf5d204a"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1093\/oxfordjournals.aje.a115101","article-title":"The impact of confounder selection criteria on effect estimation","volume":"129","author":"Mickey","year":"1989","journal-title":"Am. J. Epidemiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified poisson regression approach to prospective studies with binary data","volume":"159","author":"Zou","year":"2004","journal-title":"Am. J. Epidemiol."},{"key":"ref_36","unstructured":"STROBE (2020, June 19). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. Available online: https:\/\/www.strobe-statement.org\/index.php?id=available-checklists."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/S2215-0366(16)30094-3","article-title":"Suicide in children and young people in England: A consecutive case series","volume":"3","author":"Rodway","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/1753-6405.12877","article-title":"Differences by age and sex in adolescent suicide","volume":"43","author":"Lee","year":"2019","journal-title":"Aust. N. Z. J. Public Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S2215-0366(19)30214-7","article-title":"Risk of suicide and repeat self-harm after hospital attendance for non-fatal self-harm in Sri Lanka: A cohort study","volume":"6","author":"Knipe","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1177\/0004867415621391","article-title":"Risk factors for repetition of a deliberate self-harm episode within seven days in adolescents and young adults: A population-level record linkage study in Western Australia","volume":"50","author":"Hu","year":"2016","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e20173517","DOI":"10.1542\/peds.2017-3517","article-title":"Suicide after deliberate self-harm in adolescents and young adults","volume":"141","author":"Olfson","year":"2018","journal-title":"Pediatrics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1007\/s00127-014-0990-1","article-title":"Self-harm in Oxford, England: Epidemiological and clinical trends, 1996\u20132010","volume":"50","author":"Hawton","year":"2015","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1365-2125.2004.02252.x","article-title":"A multicentre study of coproxamol poisoning suicides based on coroners\u2019 records in England","volume":"59","author":"Hawton","year":"2005","journal-title":"Br. J. Clin. Pharm."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s00406-008-0839-2","article-title":"Factors associated with choice of psychotropic drugs used for intentional drug overdose","volume":"259","author":"Tournier","year":"2009","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1111\/1742-6723.12681","article-title":"Adolescent deliberate self-poisoning in South-East Melbourne","volume":"28","author":"Hiremath","year":"2016","journal-title":"Emerg. Med. Australas."},{"key":"ref_46","first-page":"e268","article-title":"The integrated motivational-volitional model of suicidal behaviour","volume":"373","author":"Kirtley","year":"2018","journal-title":"Philos. Trans. R. Soc. Lond. Ser. B Biol. Sci."},{"key":"ref_47","unstructured":"The National Institute for Health and Care Excellence (2020, June 19). Depression in Children and Young People: Identification and Management. Available online: https:\/\/www.nice.org.uk\/guidance\/ng134."},{"key":"ref_48","unstructured":"Medicines Management Programme (2020, June 19). Guidance on Appropriate Prescribing of Benzodiazepines and z-Drugs (BZRA) in the Treatment of Anxiety and Insomnia. Available online: https:\/\/www.hse.ie\/eng\/about\/who\/cspd\/ncps\/medicines-management\/bzra-for-anxiety-insomnia\/bzraguidancemmpfeb18.pdf."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Steeg, S., Quinlivan, L., Nowland, R., Carroll, R., Casey, D., Clements, C., Cooper, J., Davies, L., Knipe, D., and Ness, J. (2018). Accuracy of risk scales for predicting repeat self-harm and suicide: A multicentre, population-level cohort study using routine clinical data. BMC Psychiatry, 18.","DOI":"10.1186\/s12888-018-1693-z"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/ageing\/afp046","article-title":"Self-poisoning in older adults: Patterns of drug ingestion and clinical outcomes","volume":"38","author":"Doak","year":"2009","journal-title":"Age Ageing"},{"key":"ref_51","unstructured":"The National Institute for Health and Care Excellence (2020, June 19). Self-Harm in Over 8s: Long Term Management. NICE Guideline CG16. Available online: https:\/\/www.nice.org.uk\/guidance\/cg133\/resources\/selfharm-in-over-8s-longterm-management-pdf-35109508689349."},{"key":"ref_52","unstructured":"The National Institute for Health and Care Excellence (2020, June 19). Suicide Prevention: Optimising Medicines and Reducing Access to Medicines as a Means of Suicide. Available online: https:\/\/www.nice.org.uk\/advice\/ktt24."},{"key":"ref_53","unstructured":"O\u2019Driscoil, D.R.J., Brogan, C., and Henman, M. (2020, June 19). The DUMP Campaign. Irish Pharmacist. Available online: http:\/\/www.tara.tcd.ie\/bitstream\/handle\/2262\/56870\/IPJUN09DUMPCAMPAIGN.PDF?sequence=1&isAllowed=y."},{"key":"ref_54","unstructured":"The National Institute for Health and Care Excellence (2020, June 19). Depression in Adults with a Chronic Physical Health Problem: Recognition and Management. Available online: https:\/\/www.nice.org.uk\/guidance\/cg91."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"f403","DOI":"10.1136\/bmj.f403","article-title":"Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: Interrupted time series analyses","volume":"346","author":"Hawton","year":"2013","journal-title":"BMJ"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00127-019-01794-8","article-title":"Temporal trends in incidence of hospital-treated self-harm among adolescents in Denmark: National register-based study","volume":"55","author":"Steeg","year":"2020","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/eip.12807","article-title":"Legislation targeting head shops selling new psychoactive substances and changes in drug-related psychiatric admissions: A national database study","volume":"14","author":"Smyth","year":"2020","journal-title":"Early Interv. Psychiatry"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1192\/bjp.bp.107.043380","article-title":"Hospital care and repetition following self-harm: Multicentre comparison of self-poisoning and self-injury","volume":"192","author":"Lilley","year":"2008","journal-title":"Br. J. Psychiatry"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/eurpub\/ckt087","article-title":"Factors associated with self-cutting as a method of self-harm: Findings from the Irish National Registry of Deliberate Self-Harm","volume":"24","author":"Arensman","year":"2014","journal-title":"Eur. J. Public Health"},{"key":"ref_60","unstructured":"Health Service Executive (2020, June 19). National Clinical Programme for the Assessment and Management of Patients Presenting to the Emergency Department Following Self-Harm. Available online: https:\/\/www.hse.ie\/eng\/about\/who\/cspd\/ncps\/mental-health\/self-harm\/."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/17\/6159\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:06:09Z","timestamp":1760177169000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/17\/6159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,25]]},"references-count":60,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["ijerph17176159"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17176159","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,25]]}}}