John James Rufus, Khan Jahidur Rahman, Middleton Paul M, Huang Yao, Lin Daniel Ping-I, Hu Nan, Jalaludin Bin, Chay Paul, Lingam Raghu, Eapen Valsamma
School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia; and Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia.
School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
BJPsych Open. 2024 Dec 4;10(6):e213. doi: 10.1192/bjo.2024.763.
Rates of self-harm among children and young people (CYP) have been on the rise, presenting major public health concerns in Australia and worldwide. However, there is a scarcity of evidence relating to self-harm among CYP from culturally and linguistically diverse (CALD) backgrounds.
To analyse the relationship between self-harm-related mental health presentations of CYP to emergency departments and CALD status in South Western Sydney (SWS), Australia.
We analysed electronic medical records of mental health-related emergency department presentations by CYP aged between 10 and up to 18 years in six public hospitals in the SWS region from January 2016 to March 2022. A multilevel logistic regression model was used on these data to assess the association between self-harm-related presentations and CALD status while adjusting for covariates and individual-level clustering.
Self-harm accounted for 2457 (31.5%) of the 7789 mental health-related emergency department presentations by CYP; CYP from a CALD background accounted for only 8% ( = 198) of the self-harm-related presentations. CYP from the lowest two most socioeconomic disadvantaged areas made 63% ( = 1544) of the total self-harm-related presentations. Findings of the regression models showed that CYP from a CALD background (compared with those from non-CALD backgrounds) had 19% lower odds of self-harm (adjusted odds ratio 0.81, 95% CI 0.66-0.99).
Findings of this study provide insights into the self-harm-related mental health presentations and other critical clinical features related to CYP from CALD backgrounds that could better inform health service planning and policy to manage self-harm presentations and mental health problems among CYP.
儿童和青少年(CYP)的自我伤害率一直在上升,这在澳大利亚乃至全球都引发了重大的公共卫生问题。然而,关于来自文化和语言背景多样(CALD)的CYP自我伤害的证据却很匮乏。
分析澳大利亚悉尼西南部(SWS)地区CYP因自我伤害相关心理健康问题前往急诊科就诊与CALD状况之间的关系。
我们分析了2016年1月至2022年3月期间SWS地区六家公立医院中10至18岁CYP因心理健康问题前往急诊科就诊的电子病历。使用多水平逻辑回归模型对这些数据进行分析,以评估自我伤害相关就诊与CALD状况之间的关联,同时对协变量和个体水平聚类进行调整。
在7789例CYP因心理健康问题前往急诊科就诊的案例中,自我伤害占2457例(31.5%);来自CALD背景的CYP仅占自我伤害相关就诊案例的8%(n = 198)。社会经济最弱势的两个地区的CYP占自我伤害相关就诊案例总数的63%(n = 1544)。回归模型的结果显示,来自CALD背景的CYP(与非CALD背景的CYP相比)自我伤害的几率低19%(调整后的优势比为0.81,95%置信区间为0.66 - 0.99)。
本研究结果为来自CALD背景的CYP与自我伤害相关的心理健康就诊情况及其他关键临床特征提供了见解,可为卫生服务规划和政策提供更好的信息,以管理CYP中的自我伤害就诊情况和心理健康问题。