New research reveals concerning trends around self-harm across Greater Manchester

The number of people seeking help for self-harm in primary care (for example from their GP), dropped sharply during the first UK lockdown in 2020. By May 2021 this deficit had not returned to pre-pandemic levels, according to new research that analysed the electronic health care records in primary care of 2.8 million people across Greater Manchester.

Researchers analysed a new de-identified database that pulls together healthcare information from general practices across Greater Manchester to identify trends around self-harm by sex, age group, ethnicity and deprivation. They found a potentially concerning treatment gap for self-harm among men and people living in the most deprived areas.

The study’s* findings were published in EClinicalMedicine today. The investigation was funded by the UK Research and Innovation (UKRI) and the National Institute of Health Research (NIHR) COVID-19 rapid response call. It was also supported by additional funding and researchers from the NIHR Greater Manchester Patient Safety Translational Research Centre (GM PSTRC) – a partnership between The Northern Care Alliance NHS Foundation Trust (NCA) and The University of Manchester.

Dr Sarah Steeg, Presidential Fellow in mental health epidemiology at The University of Manchester, who worked with researchers from the GM PSTRC on this study, said: “We believe the fact the number of people accessing healthcare for self-harm didn’t return to pre-pandemic levels by May 2021 is unlikely to be because these people aren’t harming themselves. It is more likely to be because people aren’t seeking help or aren’t seeking help in the same way as they did before the pandemic.”

There has been research that’s looked at self-harm during the first wave of the pandemic. However, despite further waves of COVID-19 and ongoing national and regional restrictions that affected Greater Manchester into the autumn/winter of 2020 and the spring of 2021, little was known about how many people were visiting their GP after harming themselves during that time.

Dr Steeg, continued: “The findings of our study are concerning as the deepening health inequalities we observed during the first wave of the pandemic, in 2020, didn’t recover by the spring of 2021. This could reflect a hesitance to seek help from health services in the way people did before the pandemic.”

Researchers believe the potential treatment gap among men is particularly concerning due to the increased risk of suicide for men if they have harmed themselves.

This is the first study to be published that used the Greater Manchester Care Record, which brings together healthcare and social care information. It meant researchers could examine the number of times self-harm was recorded across primary care (for example, general practices) every month until May 2021.

Professor Niels Peek, lead of the Safety Informatics theme at the GM PSTRC, who was also part of the team that created the Greater Manchester Care Record, said: “This is an important milestone for the Integrated Care System in Greater Manchester. It tells us that we can use data from the Greater Manchester Care Record to accurately assess the impact of the pandemic on the Manchester population.”

* Temporal trends in primary care-recorded self-harm during and beyond the first year of the COVID-19 pandemic: time series analysis of electronic healthcare records for 2.8 million patients in the Greater Manchester Care Record –

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