The research is a collaboration between:

• University of Bristol (lead Professor David Gunnell)
• University of Oxford (lead Professor Keith Hawton)
• University of Manchester (lead Professor Nav Kapur)
• Avon and Wiltshire Mental Health Partnership NHS Trust
• Manchester Mental Health and Social Care Trust
• Oxford Health NHS Foundation Trust.

Over 15 collaborating researchers, service users and voluntary sector representatives are part of the research group.

There are four overlapping components to the programme:

1. A study of the management of self-harm in 32 English hospitals that aims to determine which aspects of care affect the risk of repeat self-harm

A comparison of the management (e.g. levels of assessment and admission) and outcome of self-harm in 32 hospitals across England to determine which aspects of care affect the risk of repeat self-harm and assess whether improvements in services have followed recent NICE guidance. This study is a follow-up of a study we originally conducted in 2001-2.

2. The development and piloting of contact-based interventions aimed at reducing the risk of self-harm after hospital discharge and A and E attendance for self-harm

The development and piloting of interventions based on the provision of “emergency support cards” and/ or regular contacts by letter, phone or e-mail in the year after receiving specialist mental health care. The aim of these interventions is to reduce the risk of subsequent self-harm. The cards will list telephone contact numbers and other sources of support in the event of a crisis.

3. An evaluation of the impacts on population health and suicide of recent regulations on the prescribing of co-proxamol and the purchase of paracetamol, and the impact of other prescribed medicines on suicide

1. Evaluation of the impact of national legislation restricting the prescribing of co-proxamol on its use in self-harm.
2. Investigation of whether the 1998 restrictions on paracetamol sales are set at an appropriate level, whether the guidelines are being complied with, and the long-term impact of the legislation, including possible effects on gastrointestinal bleeds due to increased use of other analgesics.
3. Evaluation of relative toxicity of antidepressants taken in overdoses and implications for regulatory activity and prescribing.

This research is based on national mortality data and data collected within the Multicentre Study of Self-harm in England project being carried out in Oxford, Manchester and Derby.

4. An assessment of the reliability of national suicide data for measuring the impact of the National Suicide Prevention Strategy and other influences on national suicide rates

A review of Coroners’ records from 12 districts in England to determine the extent to which national suicide rates, and time trends in suicide, may be over- or under-estimated when they are based on deaths given suicide and “open” verdicts by coroners (as is currently the case). Such information is critical to assessing the impact of the Suicide Prevention Strategy.