The World Health Organization defines mental health as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to the community.”[i] Mental illness, by contrast, includes “all diagnosable mental disorders or conditions that are characterized by alterations in thinking, mood, or behavior associated with distress and or impaired function.” Self-inflicted injury occurs when someone purposefully hurts themselves and is an indication that a person’s mental wellbeing is compromised. Individuals admitted to the emergency room for self-inflicted injury may or may not have intended to commit suicide; however, non-suicidal self-inflicted injuries are an indication that the person is at a higher risk of attempted suicide.[ii] Suicide or self-harm behaviors have lasting, harmful impacts on individuals, families, and communities.[iii]
The determinants of mental health can lie in a complex interplay between structural factors (e.g. the presence or lack of safety net services), individual exposures (e.g. adverse childhood experiences, poverty, illness, and maltreatment during childhood), and genetics. Mental illness disproportionately impacts certain vulnerable populations such as the homeless, the incarcerated, and those leaving the child welfare system. In the absence of support, intervention, or treatment, mental health disorders can readily worsen over time, leading to impaired quality of life, disability, hospitalization, institutionalization, incarceration, suicide and self-injury, and/or death. [iv], [v]
The age-adjusted adult ER admission rates for self-inflicted injury have historically been three times as high in 94102 compared to the city as a whole. Between the two time periods, 2009-2011 and 2012-2014, the rate stayed the same citywide, but there was a statistically significant increase in 94102.
California Office of Statewide Health Planning and Development, 2009-2014.
[ii] New York State Department of Health. Self-Inflicted Injury Prevention, Children Ages 10 to 19 Years. November 2011. Retrieved here: https://www.health.ny.gov/prevention/injury_prevention/children/fact_sheets/10-19_years/self-inflcited_injury_prevention_10-19_years.htm.
[iv] San Francisco Health Improvement Partnership. “San Francisco Community Health Needs Assessment 2016.” San Francisco, CA: San Francisco Department of Public Health, 2016.
[v] San Francisco Health Improvement Partnership. “San Francisco Community Health Needs Assessment 2016: Appendices.” San Francisco, CA: San Francisco Department of Public Health, 2016.