Rates, risk factors & methods of self harm among minority ethnic groups in the UK: a systematic review

We undertook a systematic literature review of research about self harm that compared at least two ethnic groups in the United Kingdom.25 publications from 1765 titles and abstracts met our inclusion criteria. There was higher rate of self harm among South Asian women, compared with South Asian men and White women. In a pooled estimate from two studies, compared to their white counterparts, Asian women were more likely to self harm (Relative Risk 1.4, 95%CI: 1.1 to 1.8, p = 0.005), and Asian men were less likely to self harm (RR 0.5, 95% CI: 0.4 to 0.7, p < 0.001). Some studies concluded that South Asian adults self-harm impulsively in response to life events rather than in association with a psychiatric illness. Studies of adolescents showed similar methods of self harm and interpersonal disputes with parents and friends across ethnic groups. There were few studies of people of Caribbean, African and other minority ethnic groups, few studies took a population based and prospective design and few investigated self harm among prisoners, asylum seekers and refugees.This review finds some ethnic differences in the nature and presentation of self harm. This argues for ethnic specific preventive actions. However, the literature does not comprehensively cover the UK's diverse ethnic groups.Non-fatal self harm (SH) is common [1]. It places significant burden on care services. The degree of suicidal intent is often difficult to assess, but SH is the most important risk factor for later completed suicide [2,3] and future self-harm [4]. Mental distress and illness are both risk factors for suicide and self harm. Though there are many studies that show ethnic variations in prevalence of mental illness, and access to care and treatment [5], few have considered the cultural epidemiology of self harm.Cross cultural investigations of self harm and suicide are necessary to inform future preventive initiatives if these are to be effective across diverse ethnic groups [6,7]. Cultural