• Joanna Stevens, James Price, Antonia Hazlerigg, Sarah McLachlan, and Ed Benjamin Graham Barnard.
• Department of Research, Audit, Innovation and Development, East Anglian Air Ambulance, Norwich, UK joanna.stevens@eaaa.org.uk.
• Emerg Med J. 2021 Nov 1; 38 (11): 842-845.

IntroductionThere is significant interest in the mental health impact of the COVID-19 pandemic. Helicopter Emergency Medical Services (HEMS) attend the most seriously unwell and injured patients in the community; their data therefore present an early opportunity to examine self-harm trends. The primary aim was to compare the incidence of deliberate self-harm incident (DSH-I) encounters by HEMS before and during the first wave of COVID-19.MethodsData were obtained from all three East of England HEMS: total number of activations and stand-downs, number of DSH-I activations and stand-downs, self-harm mechanism and number of 'severe' DSH-I patient encounters, in two 61-day periods: 1 March to 30 April in 2019 (control) and 2020 (COVID-19). Severe DSH-I was defined as cardiac arrest and/or died prehospital. Proportions were compared with a Fisher's exact test.ResultsThere were a total of 1725 HEMS activations: n=981 (control) and n=744 (COVID-19), a decrease of 24.2% during COVID-19. DSH-I patient encounters increased by 65.4%: n=26 (control) and n=43 (COVID-19). The proportion of encounters that were DSH-I and severe DSH-I both significantly increased during COVID-19: p=0.002 and p=0.001, respectively. The absolute number of hangings and falls from height both approximately tripled during COVID-19, whereas the number of other mechanisms remained almost constant.ConclusionDespite a reduction in overall HEMS patient encounters, there were significant increases in both the proportion of DSH-Is and their severity attended by HEMS during the first wave of the COVID-19 pandemic in the East of England.© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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