New study finds girls in rural B.C. at highest risk of self-poisoning
VANCOUVER – Girls age 10 to 19 living in rural B.C. communities with poor access to local mental health services are at highest risk of intentionally poisoning themselves.
This is a key finding in a study led by researchers from the BC Injury Research and Prevention Unit (BCIRPU), published recently in the British Columbia Medical Journal. The study characterizes self-poisoning among 10- to 19-year-olds in B.C. between 2009 and 2017. Using hospital and census data as well as the locations of mental health services throughout the province, researchers found that self-poisoning rates were highest in rural areas with poorly distributed mental health services compared to urban regions.
“This reveals an urgent public health issue in B.C.—one that physicians can act on by advocating for greater access to youth mental health services in high-risk regions,”
says Dr. Ian Pike, BCIRPU director, professor in the department of pediatrics at the University of British Columbia, and investigator with BC Children’s Hospital.
The study found that 81 per cent of the children and youth who poisoned themselves were girls.
The most common reason for adolescent self-harm is the desire to relieve psychological pain. Given the recent increases in depression diagnoses and antidepressant prescriptions for girls age 12 to 19, mental health and antidepressant accessibility may have contributed to increased self-poisoning rates among girls.
“Although antidepressants can increase young people’s risk of suicidal thoughts, the benefits of antidepressant treatment greatly outweigh the potential dangers,” Dr. Pike says. “Physicians should monitor young patients for signs of mental health concerns, closely monitor those who are prescribed antidepressants and discuss alternative coping strategies.”
Quick Facts:
- Self-poisoning refers to purposely self-inflicted poisoning, including both attempted suicide and non-suicidal self-harm events.
- Overdoses from all drugs (including illegal drugs) were included in the study, as long as the individual was purposely poisoning themselves. Unintentional drug overdoses were not included.
- The most common substance used was non-opioid painkillers (e.g. acetaminophen and ibuprofen), while the second most common substance was medication for anxiety and depression.
The BC Injury Research and Prevention Unit (BCIRPU) has worked to reduce the societal and economic burden of injury in British Columbia since 1997. Through high-quality and comprehensive injury data, evidence-based practices, co-ordination and collaboration, the Unit has maintained a successful program of injury surveillance and research, which has contributed to the understanding and prevention of injury in B.C. and beyond. Serving as a hub, BCIRPU plays a central role in co-ordinating and supporting injury prevention initiatives throughout the province and Canada. The Unit is located at BC Children’s Hospital in Vancouver, Canada, and is a core research program within the BC Children’s Hospital Research Institute’s Evidence to Innovation Theme. www.injuryresearch.bc.ca
BC Children’s Hospital, a program of the Provincial Health Services Authority provides expert care for the province’s most seriously ill or injured children, youth and young adults, including newborns. Child and Youth Mental Health provides a diverse range of specialized and one-of-a-kind tertiary mental health and substance use services for children, adolescents and young adults across the province. For more information, visit http://www.bcchildrens.ca/ or follow us on Twitter @BCChildrensHosp.
The Provincial Health Services Authority (PHSA) plans, manages and evaluates selected specialty and province-wide health care services across BC, working with the five geographic health authorities to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca or follow us on Twitter @PHSAofBC.
Media Contact:
Afton Doe
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BC Injury Research and Prevention Unit
403-392-4390
Afton.doe@bcchr.ca
PHSA Media line: 778.867.7472
- distress when a child was in pain and when a family was grieving; and
- sadness in the event they were not able to save a child in their care.
- concern for the injured child and the child’s family;
Particularly traumatic events, such as those involving vivid sights and sounds (e.g., families holding each other and having extreme reactions), stuck with the practitioners, having long-lasting impressions on them and causing them to re-live these events in the years following their exposure.
Even after their shift was over, practitioners said that they changed how they approached parenting and how they perceived safety during play as a result of witnessing these traumatic events. They reported having more knowledge of the causes and consequences of severe injuries, such as those that require hospitalization or emergency care. For example, practitioners were more likely to enforce boundaries around where their children could play, such as by forbidding their child to play near busy streets. They also were more likely to tell their child about safe play environments and equipment, and put this equipment on their child before play, such as explaining the benefits of using helmets while riding bikes.
Practitioners were more likely to enforce boundaries around where their children could play, and use safety equipment, such as bike helmets.
Practitioners also described being concerned about their children’s play near open windows, around large bodies of water unsupervised, and in environments where firearms were present. They also expressed worry about their children’s play on trampolines and on motorized vehicles, such as ATVs. Findings related to trampoline play safety concerns were published in the journal Injury Prevention.
Observing family grief due to child injury or death affected the mental well-being of health care practitioners, drawing attention to the need for mental health supports for those involved in caring for severely injured and dying patients.
"Raise more resilient children through play...watch and see how your child handles challenging tasks without intervening right away." —Dr. Michelle Bauer
Building resilience through play
How can parents help their children build resilience? By letting them play!
The experiences that practitioners witnessed encouraged them to support their children in building resilience through play; specifically, by supporting children in learning to cope with failure, overcome fear, build self-confidence, develop distress tolerance, and regulate negative emotions. Findings related to building resilience through play were published in the journal Child: Care, Health, and Development.
Parents fostered resilience in their kids by:
- helping their kids get back on bikes after they fell off and wanted to try again;
- sitting on their hands so they did not instinctively reach for their children when their children fell down; and
- encouraging participation in challenging and thrilling activities in forests and water while safety equipment was used.
"There are a few ways that parents can raise more resilient children through play that are supported by literature and our study findings," said Dr. Bauer. "One: watch and see how your child handles challenging tasks without intervening right away."
"Two: Ask your child how they want you to help—let them tell you what makes them feel safe and happy during play. Let them lead. And three: make play both safe and exciting by encouraging risk-taking, teaching them how to avoid hazards, and using safety equipment.”
This research was supported through Drs. Bauer’s and Gilley’s receipt of a clinical and translational research seed grant from the BC Children’s Hospital Research Institute (BCCHR), Dr. Bauer’s BCCHR postdoctoral fellowship award, and additional training provided to Dr. Bauer through her participation in the Programs and Institutions Looking to Launch Academic Researchers (PILLAR) program through ENRICH, a national organization training perinatal and child health researchers.
Learn more about the study through two infographic posters:
Graphics and posters by Milica Radosavljevic
