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IRS Mental Health Services in the Region of Southern Denmark

Inadequate Data on Self-Harm and Suicide Attempts

The information gathered on individuals arriving at the nation's emergency departments after self-harming or attempting suicide is found to be lacking, according to a recent study from the University of Southern Denmark. This shortfall in data collection could significantly impact the treatment these patients receive.

By Nana Olejank Hansen, , 5/10/2024

When a patient arrives at the emergency department following self-harm or a suicide attempt, it is vital to accurately record the injury to ensure they receive the appropriate care.

In a typical emergency department, the primary focus is on treating physical injuries. Due to this emphasis on physical conditions and accidents, the coding of suicide attempts may frequently be overlooked. Similarly, in psychiatric emergency departments, the attention is predominantly on the patient's symptoms rather than the suicide attempt itself.

- The system for coding self-harm or suicide attempts in psychiatric records is complex and requires additional entries. And due to time constraints or staffing shortages, recording these incidents is not always assured, Sarah Grube Jakobsen explains. She is a PhD student at the Department of Regional Health Research at SDU and Mental Health Services in the Region of Southern Denmark.

Registration and coding at hospitals

All hospital inquiries—both in general and psychiatric settings—are documented using diagnostic codes. These codes and their accompanying descriptions enable healthcare professionals to communicate consistently. This standardization not only facilitates the sharing of information but also simplifies the extraction of statistics for purposes such as prevention.

Source: The Danish Health Data Authority (in Danish)

Need for Improved Data to Enhance Interventions

Sarah Grube Jakobsen is the lead author of a recent study examining the registration practices for suicide attempts and self-harm. This research aligns with a new national action plan aimed at preventing such incidents, specifically focusing on enhancing the underlying data infrastructure.

It has become evident that not all suicide attempts are recorded. Moreover, distinguishing between self-harm and suicide attempts is crucial due to its implications for preventing future incidents.

-When we, as researchers, extract data and develop an overview of patients' risk profiles for preventive purposes, it becomes crucial to distinguish between known self-harm and individual suicide attempts, adds Sarah Grube Jakobsen, and continues:

-First and foremost, it is crucial to raise awareness of this issue, as understanding the problem is a prerequisite for implementing improvements that can aid those at risk of suicide.

Potential Improvements Identified

The study involved interviews with 20 professionals who provided insights into possible enhancements. This process yielded eight specific recommendations.

These recommendations have potential benefits for both immediate and future applications. In the short term, raising awareness through email reminders or handy pocket cards is effective. Over the long term, implementing a simplified system for data registration would be ideal.

Eight suggestions for measures to improve data.

  1. Visible and simple instructions for healthcare staff
  2. Ensure that there are medical secretaries to perform quality assurance of coding data
  3. Communicating methods to double-check if the relevant diagnostic codes are being used
  4. Testing alternatives for patient check-in to improve communication
  5. Random checks
  6. Better data flow between somatic and psychiatric emergency departments through structured collaboration
  7. Simpler coding functions across sectors and healthcare professionals
  8. Evaluate the potential for financial incentives to ensure accurate coding of self-harm incidents and suicide attempts.

Source: Jakobsen et al., 2024

Meet the researcher

Sarah Grube Jakobsen is a PhD student at the Department of Regional Health Research, SDU. She is affiliated with Mental Health Services in the Region of Southern Denmark, Aabenraa, and the Centre for Suicide Research.


The study “Opening the black box of registration practice for self-harm and suicide attempts in emergency departments: a qualitative study” has been published in BMC Primary Care.

Read the study

Editing was completed: 10.05.2024