TY - JOUR
T1 - Self-harm among in-school and street-connected adolescents in Ghana
T2 - A cross-sectional survey in the Greater Accra region
AU - Quarshie, Emmanuel Nii Boye
AU - Shuweihdi, Farag
AU - Waterman, Mitch
AU - House, Allan
N1 - Publisher Copyright:
©
PY - 2021/1/26
Y1 - 2021/1/26
N2 - Objectives To identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana. Design A cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data. Setting Three contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks). Participants A regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13-21 years. Outcome measures Participants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities. Results The lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56). Conclusions Self-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.
AB - Objectives To identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana. Design A cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data. Setting Three contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks). Participants A regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13-21 years. Outcome measures Participants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities. Results The lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56). Conclusions Self-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.
KW - child & adolescent psychiatry
KW - non-accidental injury
KW - public health
KW - suicide & self-harm
UR - http://www.scopus.com/inward/record.url?scp=85100307753&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2020-041609
DO - 10.1136/bmjopen-2020-041609
M3 - Article
C2 - 33500283
AN - SCOPUS:85100307753
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 1
M1 - e041609
ER -