Gender differences in epidemiology and medical service utilisation among self-harm patients seeking treatment at an urban hospital in South Africa

Gender differences in patterns of self-harm in developed countries are well documented. Little is however known about gender differences in the epidemiology of self-harm in South Africa (SA) and about gender differences in medical service utilisation among self-harm patients. We set out to investigate gender differences in demographic, socio-cultural, clinical characteristics and medical service utilization of self-harm patients presenting at an urban hospital in SA. Demographic, socio-cultural, and clinical data were collected for 200 consecutive emergency room presentations of self-harm. Bivariate statistical and logistic regression analysis was employed to identify significant gender differences. Males constituted 40.5% of the sample. Male self-harm patients were more likely than women to have dependants, to injure themselves by hanging or laceration, to cite psychiatric illness as the reason for self-harm and to be admitted to an emergency psychiatric ward. Women self-harm patients were more likely than men to use prescription medications, cite family conflict as the precipitant of their self-harm, and to be treated in the emergency room and discharged. The proportion of males in the sample was higher than expected given what is known about gender differences in the prevalence of self-harm in SA. These findings draw attention to how contextual factors such as barriers to accessing health care may influence epidemiological self-harm data collected in hospital settings in low and middle income countries. Data also suggest that hospital based suicide prevention interventions may fail to reach women self-harm patients in SA who do not appear to access hospital care.