# Mental health conditions are associated with increased risk of subsequent self-harm, assault and unintentional injuries in two nations

## TL;DR

Mental health conditions are linked to a higher risk of injuries like self-harm, assault, and accidents in Norway and New Zealand.

## Contribution

This study shows mental health conditions predict various injuries across two countries, beyond self-harm.

## Key findings

- Mental health conditions are associated with increased risk of unintentional injuries in New Zealand.
- Individuals with mental health conditions face higher risks of brain and head injuries.
- The associations hold across age, sex, and socioeconomic status in both countries.

## Abstract

Mental health conditions are associated with an increased risk of chronic physical diseases, but their implications for other physical health outcomes, including injuries, are less established. In this prospective cohort study, we tested whether mental health conditions antedate unintentional as well as self-harm and assault injuries, using administrative data from Norway (N = 2,753,646) and New Zealand (N = 2,238,813). In Norway, after accounting for pre-existing injuries, individuals with a primary care encounter for a mental health condition had an elevated risk of subsequent primary care-recorded injury. In New Zealand, as expected, individuals with a mental health-related inpatient hospital admission had an elevated risk of subsequent inpatient hospital-recorded self-harm injury, as well as assault injury. However, they also had an elevated risk of unintentional injuries. Associations extended to injury insurance claims. Associations were evident across mental health conditions, sex, age and after accounting for indicators of socioeconomic status. Risk was particularly increased for brain and head injuries. Patients with mental health conditions are an important group for injury prevention.

In this two-nation administrative register study (~5 million individuals), mental health conditions were linked to subsequent unintentional, self-harm and assault injuries. These results highlight the need for targeted injury prevention strategies.