More than 45 Canadians hospitalized every day due to self-injury
Report provides new measures of health system performance for mental health services
Download the report: Health Indicators 2011
June 8, 2011—In 2009–2010, approximately 17,500 Canadians—or 45 people a day—were admitted to hospital after attempting suicide or deliberately harming themselves, according to a new report from the Canadian Institute for Health Information (CIHI).
Health Indicators 2011 shows that, in 2009–2010, the most common method of self-injury leading to hospitalization was poisoning (85%), followed by cutting or piercing (10%) and strangulation (2%).
Young women age 15 to 19 were the most likely to self-injure. Women in this age group had a self-injury hospitalization rate of more than 140 per 100,000—more than double the rate of men in the same age category. However, men were three times more likely to die from self-inflicted injuries. In 2007, 16 per 100,000 men died from self-inflicted injuries, compared with 5 per 100,000 women.
“Self-injury rates can be seen as an indicator of access to community care,” says Kira Leeb, Director, Health System Performance, at CIHI. “While suicide and self-harming behaviours are very complex, they are considered largely preventable when accessible and effective community-based intervention strategies are in place. Information that can help to better identify and understand what groups are most at risk for self-injury can assist in the development of targeted prevention strategies.”
Rates of self-injury varied across the country and were higher in the territories than in the provinces. CIHI’s report shows that for most (70%) self-injury hospitalizations, the patient also had a diagnosis of mental illness. Mood disorders accounted for almost one-quarter (23%) of these diagnoses, followed by substance-related disorders (12%) and anxiety disorders (11%).
Many mental health inpatients are readmitted shortly after discharge
CIHI’s report also highlights performance measures for mental health services. In 2009–2010, about one in nine (11.4%) hospitalizations for a mental illness was followed by a readmission within 30 days of discharge. For the purpose of this study, mental illness includes anxiety disorders, mood disorders, personality disorders, schizophrenia and substance-related disorders.
“Mental health–related indicators tell us not just about the use of general hospital services, but about broader access to care and support across the system,” explains Chantal Couris, Senior Researcher, Health System Performance, at CIHI. “Readmission rates, for example, are measures of the coordination and continuity of mental health services. Not all readmissions can be avoided, but ensuring that community services are available for people after they leave the hospital may help prevent the so-called revolving door of hospitalization for those living with a mental illness.”
Two out of five (41%) mental health readmissions occurred within 7 days, and almost two-thirds (64%) took place within 14 days of discharge. Readmission was more likely when the initial hospitalization was for schizophrenia (13.2%) or a personality disorder (13.1%) than when it was for an anxiety disorder (8.9%). In the regions where comprehensive emergency department data was available, at least 70% of readmissions were preceded by an emergency department visit.
CIHI’s study also looks at the number of people who were hospitalized three or more times a year for mental illness. In 2008–2009, approximately one in nine (11%) mental health inpatients was hospitalized three or more times within a 12-month period. These patients accounted for 28% of all mental health hospitalizations and 27% of the total number of patient days.
“This focus on mental health–related indicators shows that there is an opportunity to examine ways to improve the current mental health system in Canada,” says Carol Adair, Adjunct Associate Professor, Departments of Psychiatry and Community Health Sciences, University of Calgary. “Ensuring individuals have a smooth transition from the hospital to effective community care and support will help them stay out of hospital and reach a level of optimal mental health and quality of life.”
About Health Indicators
CIHI’s Health Indicators annual report, produced in partnership with Statistics Canada, presents more than 40 comparable measures of health and health system performance by health region, province and territory. For the first time, this year’s report features a focus section on mental health, including new performance indicators that provide information about Canada’s mental health system. Examples of other indicators in the report are heart and stroke performance measures, Caesarean section rates and health status measures.
The report, as well as the following figures, is available on our website at www.cihi.ca.
- Figure 1 Age-Standardized Self-Injury Hospitalization Rate, by Province, Canada, 2009–2010 (Figure 2 in the report)
- Figure 2 Self-Injury Hospitalization Rate, by Sex and Age Group, Canada, 2009–2010 (Figure 5 in the report)
- Figure 3 Risk-Adjusted 30-Day Readmission Rates, by Type of Mental Illness, Canada, 2009–2010 (Figure 7 in the report)
- Figure 4 Age-Standardized Hospitalization Rates, by Type of Mental Illness, Canada, 2009–2010 (Figure 13 in the report)
Established in 1994, CIHI is an independent, not-for-profit corporation that provides essential information on Canada’s health system and the health of Canadians. Funded by federal, provincial and territorial governments, CIHI is guided by a Board of Directors made up of health leaders across the country. Our vision is to improve Canada’s health system and the well-being of Canadians by being a leading source of unbiased, credible and comparable information that will enable health leaders to make better-informed decisions.