A Systematic Review of the Effects of Urban Living on Suicidality and Self-Harm in the UK and Ireland

Satherley, Rose‐Marie; Hazell, Cassie M.; Jones, Christina; Hanna, Paul

doi:10.1007/s11524-022-00611-z

Cited by 10 publications

(10 citation statements)

References 67 publications

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“…Although our results were consistent with several Canadian studies [16,17,21], research from Ireland and the United Kingdom revealed an inverse association between self-harm and rurality [24,40]. That is, after controlling for deprivation, the risk of self-harm was higher in urban compared with rural areas.…”

Section: Discussionsupporting

confidence: 92%

“…The rural-urban pattern in Canada is different than in the United Kingdom and Ireland, where rates of self-harm and suicide tend to be higher in urban areas after adjusting for socio-economic deprivation [24]. In Canada, there is a pronounced gradient in rates of self-harm and suicide across levels of deprivation [25,26], though how this influences rural-urban differences is less clear.…”

Section: Introductionmentioning

confidence: 91%

“…One of the challenges for epidemiological studies in rural health is that rurality is not measured in a consistent or standardized way; this affects the comparability of results, especially across settings [24,27]. Some definitions of rurality use binary rural/urban categories based on population density [28].…”

Section: Introductionmentioning

confidence: 99%

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Self-harm and rurality in Canada: an analysis of hospitalization data from 2015 to 2019

Mahinpey

Pollock

Liu

et al. 2023

Soc Psychiatry Psychiatr Epidemiol

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Purpose The incidence of self-harm is an important indicator in suicide surveillance and a target outcome for suicide prevention. Self-harm rates vary by geographic location and rurality appears to be a risk factor. The objectives of this study were to estimate rates of self-harm hospitalization in Canada over a 5-year period by sex and age group, and examine relationships between self-harm and rurality. Methods Hospitalizations related to self-harm were identified in a national dataset (the Discharge Abstract Database) for all patients aged 10 years or older who were discharged from hospital between 2015 and 2019. Self-harm hospitalization rates were calculated and stratified by year, sex, age group, and level of rurality, as measured using the Index of Remoteness. A Poisson regression was fit to estimate rate ratios for the levels of rurality. Results Rates of self-harm hospitalization were higher for females than males across all levels of rurality and increased with each level for both sexes, except for among young males. The widest rural-to-urban disparities were observed for the 10–19 and 20–34-year old age groups. Females aged 10–19 in very remote areas had the highest self-harm hospitalization rate. Conclusion The rate of self-harm hospitalization in Canada varied by sex, age group, and level of rurality. Clinical and community-based interventions for self-harm, such as safety planning and increased access to mental health services, should be tailored to the differential risks across geographic contexts.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 91%

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Self-harm and rurality in Canada: an analysis of hospitalization data from 2015 to 2019

Mahinpey

Pollock

Liu

et al. 2023

Soc Psychiatry Psychiatr Epidemiol

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“…Attention can be ultimately directed towards natural elements and away from negative emotions, leading to a reduction in stress. Despite the known negative associations between urban living and health outcomes [ 25 , 26 ], recent studies have shown that exposure to certain urban environments can be beneficial for well-being [ 27 , 28 ]. Historic and cultural environments especially have emerged as offering the most restorative potential of urban environments [ 21 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ], although the restorative effect of historic settings seems to be smaller than that of natural environments [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

Exposure to Green, Blue and Historic Environments and Mental Well-Being: A Comparison between Virtual Reality Head-Mounted Display and Flat Screen Exposure

Reece

Bornioli

Bray

et al. 2022

IJERPH

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Improving the mental health of urban residents is a global public health priority. This study builds on existing work that demonstrates the ability of virtual exposure to restorative environments to improve population mental health. It compares the restorative effects of green, blue and historic environments delivered by both flat screen and immersive virtual reality technology, and triangulates data from psychological, physiological and qualitative sources. Results from the subjective measure analyses showed that exposures to all the experimental videos were associated with self-reported reduced anxiety and improved mood, although the historic environment was associated with a smaller reduction of anxiety (p < 0.01). These results were supported by the qualitative accounts. For two of the electroencephalography (EEG) frequency bands, higher levels of activity were observed for historic environments. In relation to the mode of delivery, the subjective measures did not suggest any effect, while for the EEG analyses there was evidence of a significant effect of technology across three out of four frequency bands. In conclusion, this study adds to the evidence that the benefits of restorative environments can be delivered through virtual exposure and suggests that virtual reality may provide greater levels of immersion than flat screen viewing.

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“…This protective effect might be also disease-specific as social-environmental activation plays a major role in specific psychiatric diseases, such as depression. Suicidality and self-harm (as other major psychiatric clinical features) are higher in cities than in the countryside in the United Kingdom and Ireland ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

City Environment and Occurrence of Neural Autoantibodies in Psychiatric Patients

et al. 2022

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BackgroundCity living might lead to a higher risk of psychiatric disease, but to date there is no evidence of any correlation between an urban environment and the occurrence of neural autoantibodies in psychiatric disease. Our aim is to identify whether the number of patients with and without neural autoantibodies living in diverse rural and urban environments differ.MethodsWe enrolled retrospectively a cohort of 167 psychiatric patients via a cross-sectional design from the Department of Psychiatry and Psychotherapy University Medical Center Göttingen and determined serum and/or CSF neural autoantibodies in them. The patients live in the German states of Lower Saxony, Thuringia, and Hessen. Their data were investigated in conjunction with the location of their primary residence. We categorized them into five different categories depending upon their primary residence: one rural and four different urban environments depending on their population numbers.ResultsWe identified 36 psychiatric patients with neural autoantibodies, and 131 psychiatric patients with none. In total, 24 psychiatric patients with neural autoantibodies were classified as sharing a possible, probable, or definitive autoimmune origin according to our recently set criteria. We observed as a non-significant trend that more psychiatric patients with neural autoantibodies and a probable or definitive autoimmune origin (45.8%) live in a major city with over 100,000 inhabitants than do psychiatric patients presenting no evidence of autoantibodies (26.4%). However, we identified no relevant differences between (1) psychiatric patients with and without neural autoantibodies or between (2) psychiatric patients with a possible, probable, or definitive autoimmune origin and those without such autoantibodies in relation to the diverse rural and urban environmental settings.ConclusionThe inherently different aspects of rural and urban environments do not appear to be relevant in determining the frequency of neural autoantibodies in psychiatric patients in Lower Saxony, Thuringia, and Hessen in Germany. Furthermore, large-scale studies involving other states across Germany should be conducted to exclude any regional differences and to examine the tendency of a higher frequency in large cities of autoimmune-mediated psychiatric syndromes.

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A Systematic Review of the Effects of Urban Living on Suicidality and Self-Harm in the UK and Ireland

Cited by 10 publications

References 67 publications

Self-harm and rurality in Canada: an analysis of hospitalization data from 2015 to 2019

Self-harm and rurality in Canada: an analysis of hospitalization data from 2015 to 2019

Exposure to Green, Blue and Historic Environments and Mental Well-Being: A Comparison between Virtual Reality Head-Mounted Display and Flat Screen Exposure

City Environment and Occurrence of Neural Autoantibodies in Psychiatric Patients

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