Self-harm hospitalizations in Germany between 2020 and 2024: an analysis of administrative data
Abstract
Background: Self-harm is a strong predictor of suicide death and a major public health concern. Internationally, hospitalizations due to self-harm are used within suicide surveillance frameworks and serve as an important indicator of population mental health. Despite its considerable potential, hospital data are not yet systematically utilized for the purpose of monitoring suicidality in Germany.
Methods: We analyzed publicly available aggregated administrative data from all German hospitals from 2020 to 2024. Self-harm hospitalizations were identified using ICD-10-GM code X84.9! (“intentional self-harm”), which covers self-inflicted injury or poisoning regardless of suicidal intent. Analyses examined time trends overall as well as by sex, age, and general versus psychiatric hospital settings.
Results: A total of 15,536 hospitalizations due to self-harm were identified for 2024, including 1,664 in general and 13,872 in psychiatric hospitals. Overall, 75% occurred among female patients, 45% among individuals younger than 18 years, and 69% among those younger than 30 years. We observed an increase in self-harm hospitalizations between 2020 and 2021 (+9% in general hospitals, +14% in psychiatric hospitals), driven primarily by an increase in admissions among female patients. While self-harm admissions in general hospitals returned to pre-2021 levels by 2022, psychiatric hospitalizations remained elevated through 2024.
Conclusions: Administrative hospital records allow for the monitoring of self-harm hospitalizations and their temporal trends. Combined with complementary sources such as survey and emergency department data, they could provide a comprehensive empirical basis for suicide surveillance and prevention. In line with previous findings, adolescents, young adults, and women emerge as key target groups for prevention, particularly in light of the observed increases in self-harm hospitalizations in recent years.
Key messages: • Hospitalizations due to self-harm increased notably in 2021, with psychiatric admissions remaining elevated through 2024, disproportionately affecting adolescents, young adults and women.
• Administrative hospital data are a promising yet underutilized source for monitoring self-harm in Germany, enabling identification of trends and high-risk groups.
Related
- A 25‐Year Nationwide Analysis of Mortality Trends due to Intentional Self‐Harm by Hanging, Strangulation, and Suffocation
- Tobacco and alcohol use in Germany: a cross-sectional study about associations with the self-reported ability to find, understand and judge health information
- A systemic approach to self-harm in schools in Poland – a policy brief
- Predictors of suicide attempt in adolescents with a history of self-harm: a machine learning study combining psychosocial and actigraphy measures
- Interpersonal violence and substance use: mental health and self-harm/suicide among Mexicans in VDS-UMS in the United States
BibTeX
@article{talamo2026selfharm,
title = {{Self-harm hospitalizations in Germany between 2020 and 2024: an analysis of administrative data}},
author = {J Talamo and C Schlump and MA Gonzalez Alvarez and J Thom and O Tuncer and M Fahrenwald and L Walther},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.172},
url = {https://doi.org/10.1093/eurpub/ckag169.172},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Self-harm hospitalizations in Germany between 2020 and 2024: an analysis of administrative data
AU - J Talamo
AU - C Schlump
AU - MA Gonzalez Alvarez
AU - J Thom
AU - O Tuncer
AU - M Fahrenwald
AU - L Walther
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.172
UR - https://doi.org/10.1093/eurpub/ckag169.172
AB - Background: Self-harm is a strong predictor of suicide death and a major public health concern. Internationally, hospitalizations due to self-harm are used within suicide surveillance frameworks and serve as an important indicator of population mental health. Despite its considerable potential, hospital data are not yet systematically utilized for the purpose of monitoring suicidality in Germany. Methods: We analyzed publicly available aggregated administrative data from all German hospitals from 2020 to 2024. Self-harm hospitalizations were identified using ICD-10-GM code X84.9! (“intentional self-harm”), which covers self-inflicted injury or poisoning regardless of suicidal intent. Analyses examined time trends overall as well as by sex, age, and general versus psychiatric hospital settings. Results: A total of 15,536 hospitalizations due to self-harm were identified for 2024, including 1,664 in general and 13,872 in psychiatric hospitals. Overall, 75% occurred among female patients, 45% among individuals younger than 18 years, and 69% among those younger than 30 years. We observed an increase in self-harm hospitalizations between 2020 and 2021 (+9% in general hospitals, +14% in psychiatric hospitals), driven primarily by an increase in admissions among female patients. While self-harm admissions in general hospitals returned to pre-2021 levels by 2022, psychiatric hospitalizations remained elevated through 2024. Conclusions: Administrative hospital records allow for the monitoring of self-harm hospitalizations and their temporal trends. Combined with complementary sources such as survey and emergency department data, they could provide a comprehensive empirical basis for suicide surveillance and prevention. In line with previous findings, adolescents, young adults, and women emerge as key target groups for prevention, particularly in light of the observed increases in self-harm hospitalizations in recent years. Key messages: • Hospitalizations due to self-harm increased notably in 2021, with psychiatric admissions remaining elevated through 2024, disproportionately affecting adolescents, young adults and women. • Administrative hospital data are a promising yet underutilized source for monitoring self-harm in Germany, enabling identification of trends and high-risk groups.
SN - 1101-1262
SN - 1464-360X
ER -