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Self-Harm – a cohort study in Taiwan

This is a study of people living in Nantou County in Taiwan who deliberately self-harm, attempt or commit suicide. Nantou was the site of the Chi-Chi earthquake in September 1999 which resulted in 927 deaths and more than 57,000 houses destroyed or uninhabitable. After the earthquake, suicide became one of the most important public health problems in the disaster area: between 2000 and 2002, Nantou County had the highest suicide rate in Taiwan.

This study sets out to investigate the relationship between demographic factors, suicide and deliberate self-harming, and the relationship between suicidal intent, depression and alcohol abuse.

In the last five years, the incidence of suicide has increased to more than 10 people in every 100,000 in Taiwan and has become the ninth leading cause of death in the country. One of the most important predictors of suicide is deliberate self-harm. Understanding deliberate self-harm and predictors of suicide will enable policy makers to develop strategies to help people who are suicidal.

After the earthquake, a community mental health centre was set up in Nantou County with funding from the Department of Health in Taiwan to provide mental health services for survivors. In collaboration with the local health authority, this centre established a reporting system for deliberate self-harm and suicide.

Between July 2000 and December 2002, 1,288 suicidal acts were reported. There were 1,083 acts of deliberate self-harm and 205 deaths. The reports came from health personnel, including emergency rooms, GPs and local public health nurses, as well as police, social workers, firefighters and NGO workers. The information was collected on a Suicide Register, and included age, gender, education, marital status, address, date of the self-harming incident or suicide, method and origin of information. This data is being used to analyse the demographic factors related to suicide and deliberate self-harm.

From March 2001 to July 2005, staff in Nantou Mental Health Centre began to interview and follow up cases on the Suicide Register for at least three months. They collected information about suicide intent, depression, alcohol problems, life events, family history and past history of suicide and deliberate self-harm. This data is being used to investigate risk factors.

The research is being undertaken by Dr Chin-Hung Chen who works at the Tsaotun Psychiatric Center in Taiwan which is funded the PhD study.

The research is supervised by Professor Martin Prince and Dr Rob Stewart in the Section of Epidemiology.

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