Exact frequency is impossible to determine because milder cases may not be referred to hospital, or even present to health services at all. Community surveys indicate a lifetime prevalence of up to 5 per cent for DSH. A major epidemic occurred during the 1960s and 1970s, when self-poisoning became the commonest reason for a young person to be admitted to a medical ward. Rates have declined since then, although more than 140 000 people still present with DSH to hospital in England and Wales each year (Bennewith et al., 2004).

Non-fatal DSH is at least 10 times more common than completed suicide, although there is some evidence that rates of DSH and suicide move in tandem.

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