Self-harm is an important international public health issue and a risk factor for future suicide.1,2 Although self-harm is more common in women than men across the lifespan, the difference in rates narrows as age increases.Reference Geulayov, Kapur, Turnbull, Clements, Waters and Ness3,Reference Clements, Hawton, Geulayov, Waters, Ness and Rehman4 In a previous study in England, rates of self-harm for people aged 40–59 years were 449 per 100 000 population in women and 363 per 100 000...