Background: Deliberate self-harm (DSH) represents a largely under-recognized public health crisis in low- and middle-income countries, particularly affecting young adults. Despite its significant contribution to morbidity, mortality, and long-term psychological and socioeconomic consequences, it continues to receive insufficient attention in public health agendas. We aim to describe the socio-demographic and clinical characteristics of patients who presented with DSH to a secondary care hospital in South India.
Methods: This retrospective study was conducted using electronic medical records of patients presenting with DSH to the Emergency Department of a secondary care hospital in South India between 2019 and 2024. Data on sociodemographic characteristics, methods of self-harm, clinical features, and referral outcomes were extracted and analyzed. Descriptive statistics were used to summarize the findings.
Results: Of 61,797 Emergency Department visits over five years, 179 (0.29%) were due to DSH. The mean (SD) age was 31.8 (14.1) years, with a slight female predominance (50.8%); most patients were aged 15–30 years (58.7%). Toxic ingestion was the predominant method, with agrochemicals forming the largest group (31.8%), followed by medication overdose (15.1%) and corrosive ingestion (11.2%); hanging accounted for 17.9% of cases. Most patients were referred to tertiary centres (64.8%), while 22.3% were admitted locally. Emergency department mortality was 1.7%.
Conclusion: DSH remains a substantial public health burden in India, especially among young adults. The high proportion of impulsive, high-lethality attempts highlights the urgent need to strengthen emergency mental health services, pesticide regulation, and preventive strategies at the secondary care level.