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Commission more teen mental health and alcohol services

UK teen poisonings rise sharply in past 20 years – worst hit are girls and deprived groups

Louise Prime

Tuesday, 17 May 2016

Commissioners should increase the provision of child and adolescent mental health and alcohol treatment services to reflect the increasing rate of intentional and alcohol-related poisoning among adolescents in the UK, urge the authors of UK primary care-led research. Their large study*, published today in Injury Prevention, revealed a sharp rise in cases of poisoning in teenagers in the UK over the past 20 years, particularly among girls and young women and in more socioeconomically deprived groups.

Researchers led from the University of Nottingham’s Division of Primary Care wanted to find out more about time trends in the incidence and risk factors for poisonings in the UK, so they examined anonymised general practice records submitted to the UK Health Improvement Network database (THIN) between 1992 and 2012 on deliberate and unintentional poisonings for more than 1.3 million 10-17 year olds. They used these data to calculate incidence rates per 100,000 person-years for all poisonings; intentional poisonings; unintentional poisonings; poisonings of unknown intent; and alcohol-related poisonings, broken down by age, sex, calendar period and level of socioeconomic deprivation (according to the Townsend Index).

During the study period, there were 17,862 poisonings overall – and the annual rate rose by 27% between 1992 and 2012. The greatest increase occurred in intentional poisonings in 16-17-year-old girls, and alcohol-related poisonings in 15-16-year-old girls, both of which roughly doubled. Nearly two-thirds (64%) of poisonings between 2007 and 2012 were recorded as intentional and only 4% as unintentional; 16% were alcohol-related; and in 16% intent was recorded as unknown.

The marked sex differences in both intentional and alcohol-related poisonings widened over time. The overall rate of poisonings in boys and young men was less than half that in girls and young women; for alcohol-related poisonings it was 10% lower, and for intentional poisonings it was 80% lower.

The study authors also found that a strong socioeconomic gradient for all poisonings persisted over time, with rates among the most deprived quintile 2.63 times higher than in the least deprived. They suggested that this association might reflect differences between the groups in levels of mental anguish, stress, and social and psychological support.

They questioned whether the increasing rates of poisonings that they found among young women reflect real changes – or other factors such as increased health seeking-behaviour, changes in GP coding practices, or popular trends, such as clinicians perceiving intentional poisonings as more frequent and therefore recording events as such.

But, the researchers added: “One potential explanation for the increase in alcohol poisonings over time is increased availability, with the relative affordability of alcohol in the UK increasing steadily between 1980 and 2012, licensing hours having increased since 2003, and numbers of outlets increasing alongside alcohol harm.”

They concluded: “Since intentional and alcohol-related adolescent poisoning rates are increasing, both child and adolescent mental health and alcohol treatment service provision needs to be commissioned to reflect this changing need. Social and psychological support for adolescents should be targeted within more deprived communities to help reduce the current social inequalities.”

* Tyrrell EG, Orton E, Tata LJ. Changes in poisonings among adolescents in the UK between 1992 and 2012: a population based cohort study. Inj Prev 2016; 0: 1–7. doi:10.1136/injuryprev-2015-041901.

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