Self-Harm and Crash Risk

admin driver behaviour, The Issues

Could some crashes be an act of self harm?

In Australia up to 4,700 young people are hospitalised per year following a crash.  There are 24,087 young people hospitalised per year following self harm.  But is there a link?
Young people are particularly at risk for mental health problems.  These problems may lead to self-harm and suicide.  Deliberate motor vehicle crashes may be caused by young drivers as a means of self-harm or suicide.  Other factors that are associated with self-harm also might increase the risk of crashing, e.g. alcohol, disturbed sleep, and poor impulse control.
To date, most studies have looked at young people who have died in crashes.  The mental health status of those drivers was determined after their deaths. However, a new Australian study has examined the mental health status of young drivers before they crash, and looked at associations between this and their risk of crashes not causing death.  In this study, newly licensed NSW drivers aged 17-24 were asked about their self-harm behaviour.  Of 20,822 surveyed, 871 (4%) of young drivers engaged in self-harm behaviours (such as cutting, burning, self-battering, poisoning and self-harm with lethal intent).  Self-harm was most commonly reported by:

  • The youngest drivers (17 year olds)
  • Females
  • Those born in Australia
  • Rural and regional drivers
  • Those who had driven more
  • Those reporting more risk taking behaviour
  • Those with a history of drug or alcohol abuse
  • Those with less hours of sleep per night.

This Australian study found that young drivers, who had previously reported self-harm behaviours, were at a 42% higher risk of crash than those who didn’t report the behaviours.  This increased risk remained (37% higher risk) even after accounting for other factors  such as age, sex, average driving hours per week, previous crashes, psychological distress, and amount of sleep.  Of the 871 young drivers who reported self-harm, 88 (10%) had at least one crash and 84% of those who had a crash were involved in multiple-vehicle incidents affecting other road users.
Reducing the risk of crash in young drivers is important.  The results of this study highlight a need for programs managing road behaviour in young people with poor mental health.  There is some evidence that programs designed to improve the general resilience of young people can also reduce the risk of road-related risky behaviours.  Further research on this topic will be essential.  In the interim, general practitioners, teachers, parents and youth groups need to identify self-harming behaviour so that they can help self-harmers seek appropriate treatment.

Factbase Recomendations

Young drivers who engage in self-harm are at increased risk of crash.  Effective interventions to address self-harm should be expanded to include potential vehicle-related risk.  These interventions should be assessed to determine if they decrease the risk of crash in this group of young drivers.

References

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Martiniuk ALC, Ivers RQ, Glozier N, Patton GC, Lam LT, Boufous S, Senserrick T, Williamson A, Stevenson M & Norton R. Self-harm and risk of motor vehicle crashes in youth: the DRIVE prospective cohort study. Canadian Medical Association Journal( accepted 25 June 2009 in press).

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Self-Harm and Crash Risk