The AKU self-harm registry is a hospital-based system that monitors the occurrence of hospital-treated self-harm while gathering data on individuals who present to AKU-Hospital emergency departments after engaging in self-harm. According to WHO, self-harm is defined as "an act with non-fatal outcome in which an individual deliberately initiates a non-habitual behaviour, that without intervention from others will cause self-harm." This encompasses acts with varying degrees of suicidal intent and underlying motives, such as loss of control, a cry for help, or self-punishment.
As few nations worldwide have reliable information on self-harm, AKU has developed the Self-Harm Registry, with the Self-Harm Registry Committee (SHRC) established by the Brain and Mind Institute (BMI), to monitor the registry's development in Kenya. The committee comprises members with expertise in mental health, suicide prevention, AKU leadership and governance, and those with lived experiences. The committee created a baseline dataset to evaluate the degree of self-harm while examining trends and the circumstances surrounding the act and the individual. The AKU Electronic Health System will be used to capture data for all self-harm cases.
This Self-Harm Registry is essential as a sustainable and long-term monitoring system that can provide timely data on trends and populations at high risk of self-harm in the AKU-Hospital communities. Besides, it will assist health care workers in identifying individuals with repeated self-harm acts and risk factors relating to those recurrences over time. Furthermore, the data will contribute to addressing knowledge gaps and enhancing service provision while providing insight into service capacity and treatment needs and influencing the development, implementation, and assessment of future targeted suicide prevention interventions.
In line with the recently launched national suicide prevention strategy, our long-term goal in developing the AKU-Nairobi Self-Harm Registry is to establish a model for a national-level registry. Using the knowledge obtained by developing and monitoring the AKU-Nairobi Self-Harm Registry, our vision is to cultivate this working model for public and private hospitals across the country. The national registry's primary purpose is to monitor and evaluate the occurrences and repetition of self-harm, identify potential groups and localities, and assist services and practitioners involved with preventing suicidal behaviour.
Self-harm is one of the world's leading causes of illness and disability, with repeated self-harm frequently occurring days after an act. As self-harm is correlated with high morbidity, suicide and other causes of premature death, the Self-Harm Registry is crucial in being a long-term, sustainable monitoring resource for suicide prevention. Furthermore, it will be used in monitoring demographic changes, identifying predicting factors for recurrence, and monitoring the health response to this condition. Hence, the registry should be made a routine aspect of the country's health information system and a significant priority financially supported and endorsed by the health ministry and the national government.
By Linnet Ongeri,
Suicide Prevention Scientist
