The paradox of public holidays: Hospital-treated self-harm and associated factors

J Affect Disord. 2017 Aug 15;218:30-34. doi: 10.1016/j.jad.2017.04.058. Epub 2017 Apr 25.


Background: Recent research on the patterns of self-harm around public holidays is lacking. This study used national data to examine the patterns of hospital-treated self-harm during public holidays, and to examine associated factors.

Methods: Data on self-harm presentations to all emergency departments were obtained from the National Self-Harm Registry Ireland. The association between self-harm presentations and public holidays was examined using univariate and multivariate Poisson regression analyses.

Results: A total of 104,371 presentations of self-harm were recorded between 2007 and 2015. The mean number of self-harm presentations was 32 on public holidays. St. Patrick's Day had the highest number of presentations compared to all other public holidays, with a daily mean of 44 presentations. Across all years, self-harm presentations during public holidays had a 24% increased risk of involving alcohol consumption compared to all other days and this effect was most pronounced during the Christmas period. The association with alcohol remained significant at a multivariate level. Presentations on public holidays were more likely to attend out of normal working hours. An increase in male presentations involving self-cutting was observed on public holidays and there was an over-representation of males presenting for the first time.

Limitations: It is likely that extent of alcohol involvement in self-harm presentations reported here is an underestimate, as it was dependent on the information being recorded by the attending clinician.

Conclusions: Public holidays are associated with an elevated number of self-harm presentations to hospital, with presentations to hospital involving alcohol significantly increased on these days. Hospital resources should be targeted to address increases during public holidays, including during out-of-hours. Involvement of alcohol may delay delivery of care to these patients in emergency settings.

Keywords: Alcohol consumption; Mental health; Public holidays; Self-harm.

MeSH terms

  • Adult
  • Alcohol Drinking / psychology
  • Emergency Medical Services / statistics & numerical data
  • Female
  • Holidays*
  • Humans
  • Ireland
  • Male
  • Middle Aged
  • Registries
  • Risk Factors
  • Self-Injurious Behavior / psychology*