Deliberate Self-Harm in South India: Patterns, Outcomes and Public Health Implications from a Retrospective Study

Background: Deliberate self-harm (DSH) represents a largely under-recognized public health crisis in low- and middle-income countries, particularly affecting young adults. Despite its significant contribution to morbidity, mortality, and long-term psychological and socioeconomic consequences, it continues to receive insufficient attention in public health agendas. We aim to describe the socio-demographic and clinical characteristics of patients who presented with DSH to a secondary care hospital in South India.Methods: This retrospective study was conducted using electronic medical records of patients presenting with DSH to the Emergency Department of a secondary care hospital in South India between ۲۰۱۹ and ۲۰۲۴. Data on sociodemographic characteristics, methods of self-harm, clinical features, and referral outcomes were extracted and analyzed. Descriptive statistics were used to summarize the findings.Results: Of ۶۱,۷۹۷ Emergency Department visits over five years, ۱۷۹ (۰.۲۹%) were due to DSH. The mean (SD) age was ۳۱.۸ (۱۴.۱) years, with a slight female predominance (۵۰.۸%); most patients were aged ۱۵–۳۰ years (۵۸.۷%). Toxic ingestion was the predominant method, with agrochemicals forming the largest group (۳۱.۸%), followed by medication overdose (۱۵.۱%) and corrosive ingestion (۱۱.۲%); hanging accounted for ۱۷.۹% of cases. Most patients were referred to tertiary centres (۶۴.۸%), while ۲۲.۳% were admitted locally. Emergency department mortality was ۱.۷%.Conclusion: DSH remains a substantial public health burden in India, especially among young adults. The high proportion of impulsive, high-lethality attempts highlights the urgent need to strengthen emergency mental health services, pesticide regulation, and preventive strategies at the secondary care level.

کلیدواژه ها:

Delibrate self harm ، Suicide ، Poisoning ، Medical toxicology ، Drug Overdose