Keith Hawton

University of Oxford | OX · Department of Psychiatry

Adolescents' loneliness and self-harm have received considerable attention during the COVID-19 pandemic with concerns that the socioecological changes taking place would contribute to an escalation of both loneliness and self-harm. However, empirical evidence is scant. We estimated the prevalence of loneliness and self-harm in adolescent school pup...

Concerns have been raised about early vs. later impacts of the COVID-19 pandemic on suicidal behavior. However, data remain sparse to date. We investigated all calls for intentional drug or other toxic ingestions to the eight Poison Control Centers in France between 1st January 2018 and 31st May 2022. Data were extracted from the French National Da...

Media impact on suicide is well‐established. Groups at heightened risk of suicide, such as nurses, may be particularly influenced by poor news reporting. This study aimed to examine UK newspaper reporting of suicide of nurses and student nurses, including during the COVID‐19 pandemic. Print and online newspaper reports about suicide in nurses (incl...

Background Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods We identified suicide data from official pu...

Suicide prevention in psychiatric practice has been dominated by efforts to predict risk of suicide in individual patients. However, traditional risk prediction measures have been shown repeatedly in studies from high income countries to be ineffective. Several factors might contribute to clinicians' preoccupation with risk prediction, which can ha...

Background We examined disparities in sociodemographic and clinical characteristics and in problems preceding self-harm across levels of socio-economic deprivation (SED) in persons who presented to hospital for self-harm. Method 108,092 presentations to hospitals (by 57,306 individuals) following self-harm in the Multicentre Study of Self-harm in...

Background Evidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020. Aims To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic. Method A comprehensive search of d...

Objectives Since the start of the COVID-19 pandemic, there has been much concern and speculation about rises in suicide rates, despite evidence that suicides did not in fact increase in the first year of the pandemic in most countries with real-time suicide data. This public narrative is potentially harmful, as well as misleading, and is likely to...

Background Little is known about the perceived acceptability and usefulness of supports that adolescents have accessed following self-harm, especially since the onset of the COVID-19 pandemic.AimsTo examine the utilization and acceptability of formal, informal, and online support accessed by adolescents following self-harm before and during the pan...

Background: Deterioration in general population mental health since the start of the COVID-19 pandemic has been reported, but the impact of the pandemic on people with severe mental illness (SMI) has received less attention. Aims: To understand the impact of the early stages of the pandemic on the patients with SMI, in terms of provision of ment...

Background: Associations between sensational news coverage of suicide and increases in suicidal behavior have been well documented. Amid growing concern over the impact of the COVID-19 pandemic on suicide rates, it is especially important that news coverage adheres to recommended standards. Method: We analyzed the quality and content of print and o...

Introduction: Pesticide self-poisoning kills an estimated 110 000-168 000 people worldwide annually. Data from South Asia indicate that in 15%-20% of attempted suicides and 30%-50% of completed suicides involving pesticides these are purchased shortly beforehand for this purpose. Individuals who are intoxicated with alcohol and/or non-farmers repr...

Background There is limited recent information regarding the risk of self-harm, somatic disorders and premature mortality following discharge from psychiatric hospital in young people. Objective To measure these risks in young people discharged from a psychiatric hospital as compared with both non-affected controls and non-hospitalised affected co...

Background: People who experience homelessness are thought to be at high risk of suicide, but little is known about self-harm in this population. Aims: To examine characteristics and outcomes in people experiencing homelessness who presented to hospital following self-harm. Method: Data were collected via specialist assessments and/or hospital...

Background: Guidance in England recommends psychosocial assessment when presenting to hospital following self-harm but adherence is variable. There is some evidence suggesting that psychosocial assessment is associated with lower risk of subsequent presentation to hospital for self-harm, but the potential cost-effectiveness of psychosocial assessm...

Background Evidence on the impacts of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020. Aims To systematically review evidence on health services utilisation for self-harm during the COVID-19 pandemic. Methods A comprehensive search of multiple d...

Background: Self-harm, a significant and increasing global problem in children and adolescents, is often repeated and is associated with risk of future suicide. To identify potential interventions, we need to understand the life problems faced by children and adolescents, and by sub-groups of younger people who self-harm. Our aims were to include...

Background Very little is known about self-harm in children. We describe the characteristics and outcomes of children under 13 years who presented following self-harm to five hospitals in England. Methods We included children under 13 years who presented after self-harm to hospitals in the Multicentre Study of Self-harm in England. Information on...

Background: Over 90% of youth suicide deaths occur in low- and middle-income countries. Despite this relatively little is known about risk factors in this context. Aims: Investigate risk factors for deliberate self-harm (non-fatal) in young people in rural Sri Lanka. Methods: A prospective cohort study of 22,401 individuals aged 12-18 years wi...

Objectives: This is a protocol for a Cochrane Review (qualitative). The objectives of this review are threefold, as follows. Firstly, to assess service user experiences of emergency care following an episode of SH. Secondly, to understand how service user characteristics (e.g. gender, age, comorbidity with other illness), type of SH (e.g. method, r...

Objectives: This is a protocol for a Cochrane Review (qualitative). The objectives of this review are threefold, as follows. Firstly, to assess the content of knowledge, attitudes, and behaviours of first responders, clinicians, and non‐clinical support staff towards service users with SH presentations. Secondly, to understand how service user and...

There was a highly publicised cluster of at least ten suicides in South Wales, United Kingdom, in 2007–2008. We carried out a qualitative descriptive study using cross-case thematic analysis to investigate the experiences and narratives of eight individuals who lived in the area where the cluster occurred and who survived an episode of near-fatal s...

Background: Glutamergic system dysfunction has been implicated in the pathophysiology of bipolar depression. This is an update of the 2015 Cochrane Review for the use of glutamate receptor modulators for depression in bipolar disorder. Objectives: 1. To assess the effects of ketamine and other glutamate receptor modulators in alleviating the acu...

Aims There are substantial costs to health care systems and society associated with self-harm. Moreover, individuals who have presented to hospital following self-harm have a much higher risk of suicide within the following year compared to the general population. National guidance in England recommends psychosocial assessment when presenting to ho...

Background: Many studies have recently been conducted to assess the antidepressant efficacy of glutamate modification in mood disorders. This is an update of a review first published in 2015 focusing on the use of glutamate receptor modulators in unipolar depression. Objectives: To assess the effects - and review the acceptability and tolerabili...

Background Studies report an increasing incidence of self-harm in children and adolescents, but the extent to which this is seen in different ethnic groups is unclear. We aimed to investigate rates of emergency department presentations for self-harm in children and adolescents by ethnicity, as well as to examine their demographic characteristics, c...

Background We compared the risk of death by suicide following hospital presentation for self-harm according to site of self-cut/stab. Method We included 54 999 self-harm presentations (involving 31 419 individuals) to hospitals in the Multicentre Study of Self-harm in England (1/1/2004–31/12/2014), with mortality follow-up to 31/12/2019. Informati...

Background: The COVID-19 pandemic has caused considerable morbidity, mortality and disruption to people’s lives around the world. There are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review synthesises findings from emerging literature on incidence and prevalence of suicidal beh...

Background Whilst growing research suggests that pain is associated with suicidality in adolescence, it remains unclear whether this relationship is moderated by co-morbid depressive symptoms. The present study aimed to investigate whether the pain-suicidality association is moderated by depressive symptoms. Methods We performed secondary analyses...

Associations between sensational news coverage of suicide and subsequent increases in suicidal behaviour in the general population have been well documented. Amidst growing concern over the impact of the COVID-19 pandemic on suicide rates, it is especially important that news coverage of suicidal behaviour adheres to recommended standards for the r...

Background: Self‐harm (SH; intentional self‐poisoning or self‐injury regardless of degree of suicidal intent or other types of motivation) is a growing problem in most counties, often repeated, and associated with suicide. There has been a substantial increase in both the number of trials and therapeutic approaches of psychosocial interventions for...

Summary Background The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. Methods We sourced real-time s...

Objective An emerging body of research indicates that child sex abuse (CSA) offenders are at high risk of suicide when their offenses come to light and that those accused of accessing indecent images of children (IIOC) are at particular risk. Methods We conducted a systematic review and narrative synthesis on suicide rates and risk factors in this...

Background: Self-harm (SH; intentional self-poisoning or self-injury regardless of degree of suicidal intent or other types of motivation) is a growing problem in most countries, often repeated, and associated with suicide. Evidence assessing the effectiveness of interventions in the treatment of SH in children and adolescents is lacking, especiall...

Introduction The COVID-19 pandemic and resulting public health measures may have major impacts on mental health, including on self-harm. We have investigated what factors related to the pandemic influenced hospital presentations following self-harm during lockdown in England. Method Mental health clinicians assessing individuals aged 18 years and...

Background Rates of suicide among people in prison are elevated compared with people of similar age and sex who are living in the community. Improving assessments and interventions to reduce suicide risk requires updated evidence on risk factors. We aimed to examine risk factors associated with suicide in prisoners. Methods We did an updated syste...

Objectives Explore international consensus on nomenclatures of suicidal behaviours and analyse differences in terminology between high-income countries (HICs) and low/middle-income countries (LMICs). Design An online survey of members of the International Organisation for Suicide Prevention (IASP) used multiple-choice questions and vignettes to as...

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effects of interventions delivered in educational settings to prevent self-harm and suicide in young people (up to the age of 25) and examine whether the relative effects on repetition of self-harm are modified by education setting. Co...

Background The COVID-19 pandemic and public health measures necessary to address it may have major effects on mental health, including on self-harm. We have used well-established monitoring systems in two hospitals in England to investigate trends in self-harm presentations to hospitals during the early period of the pandemic. Method Data collected...

Background: Self‐harm (SH; intentional self‐poisoning or self‐injury regardless of degree of suicidal intent or other types of motivation) is a growing problem in most countries, often repeated, and associated with suicide. Evidence assessing the effectiveness of pharmacological agents and/or natural products in the treatment of SH is lacking, espe...

Background Ketamine has recently received considerable attention regarding its antidepressant and anti-suicidal effects. Trials have generally focused on short-term effects of single intravenous infusions. Research on patient experiences is lacking. Aims To investigate the experiences over time of individuals receiving ketamine treatment in a rout...

Introduction The COVID-19 pandemic and resulting public health measures may have major impacts on mental health, including on self-harm. We have investigated what factors related to the pandemic influenced hospital presentations following self-harm during lockdown in England. Method Mental health clinicians assessing individuals aged 18 years and...

Background Individuals attending emergency departments following self-harm have increased risks of future self-harm. Despite the common use of risk scales in self-harm assessment, there is growing evidence that combinations of risk factors do not accurately identify those at greatest risk of further self-harm and suicide. Aims To evaluate and comp...

Background: Despite the promising evidence for the effectiveness of school-based awareness programs in decreasing the rates of suicidal thoughts and suicide attempts in young people, no guidelines on the targets and methods of safe and effective awareness programs exist. Aims: This study intends to distill recommendations for school-based suicide a...

Background : Suicide on roads is receiving increased attention. However, there has been little research on non-fatal road-related self-harm. This study was conducted in order to investigate the characteristics of such acts. Method : Information on non-fatal road self-harm was extracted from a self-harm monitoring system database of self-harm prese...

Background The COVID-19 pandemic and public health measures necessary to address it may have major effects on mental health, including on self-harm. We have used well-established monitoring systems in two hospitals in England to investigate trends in self-harm presentations to hospitals during the early period of the pandemic. Method Data collecte...

Background: Although research has identified a wide range of risk factors for suicidal behaviour in prisoners, it does not establish who is most likely to act on their suicidal thoughts while incarcerated. Methods: Self-report data were collected from a random sample of 1203 adult men incarcerated across 15 prisons in Belgium, who represent 12% of...

Background: Road traffic suicides are common. However, due to the difficulty in distinguishing between motor vehicle crash fatalities and actual suicides, no official figures exist for this method of suicide. Restricting access to means is an important universal or population-based approach to suicide prevention with clear evidence of its effectiv...

Background: The COVID-19 pandemic has caused morbidity and mortality, as well as, widespread disruption to people’s lives and livelihoods around the world. Given the health and economic threats posed by the pandemic to the global community, there are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our liv...

Background Self-harm is a leading cause of morbidity in prisoners. Although a wide range of risk factors for self-harm in prisoners has been identified, the strength and consistency of effect sizes is uncertain. We aimed to synthesise evidence and assess the risk factors associated with self-harm inside prison. Methods In this systematic review an...

Objective In South Asia, up to one in five individuals who ingest pesticides for self‐poisoning and survive purchased them from a shop immediately prior to the event. Thus far, no research has taken place to determine whether interventions implemented through the pesticide sellers might be acceptable or effective, despite the hundreds of thousands...

Background A few previous studies suggest that a large number of individuals do not present at hospital following a suicide attempt, complicating recurrence prevention and prevalence estimation. Methods Data were extracted from a regular phone survey in representative samples of the French population aged 18–75 years old. Five surveys between 2000...

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of psychosocial interventions for self-harm (SH) compared to comparison types of treatment (e.g. treatment as usual, routine psychiatric care, enhanced usual care, active comparator) for adults (aged 18 years or older) who engage in SH.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of pharmacological agents or natural products for self-harm (SH) compared to comparison types of treatment (e.g. placebo or alternative pharmacological treatment) for adults (aged 18 years or older) who engage in SH.

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effects of psychosocial or pharmacological interventions for self-harm (SH) compared to comparison types of care (e.g. treatment as usual, routine psychiatric care, enhanced usual care, active comparator, placebo, alternative pharmacol...

Background Paracetamol is frequently used for intentional self-poisoning, especially in the UK, despite pack size restrictions introduced in 1998. Knowing more about paracetamol self-poisoning may identify further approaches to prevention. Methods We used data from the Multicentre Study of Self-harm in England for 2004-2014 to calculate incidence...

Background: The COVID-19 pandemic has caused widespread morbidity and mortality as well as disruption to people’s lives and livelihoods around the world; this has occurred as a result of both infection with the virus itself and the health protection measures taken to curb its spread. There are concerns that rates of suicide, suicidal behaviours and...

Background: Self-harm in young people can have a substantial negative impact on the well-being and functioning of parents and other carers. The "Coping with Self-Harm" booklet was originally developed in the UK as a resource for parents and carers of young people who self-harm, and an adaptation study of this resource was conducted in Australia. T...

Background: Media reporting may influence suicidal behavior. In-depth exploration of how self-harm and suicide are portrayed in newspaper articles in a middle-income country such as Sri Lanka is lacking. Aims: We aimed to explore how self-harm and suicide are portrayed in Sri Lankan printed newspapers. Method: Seven English- and Sinhala-language Sr...