M. DALY, M. J. KELLEHER, B. KEOHANE, C. LINEHAN and W. LORENZ
There have been numerous investigations into the different aspects of non-fatal deliberate self-poisoning, a problem which has increased rapidly and progressively over the last three and a half decades, and which currently absorbs a very large proportion of medical and psychiatric time and resources.
One type of investigation has been the ecological study, the purpose of which is to isolate the factors which contribute to the increase of deliberate self-poisoning by identifying the characteristics of the neighbourhoods in which it flourishes.
Ecological studies have been carried out in a number of cities in Britain: in Bristol ( Morganet al. 1975); in Oxford ( Bancroftet al.. 1975); and Edinburgh ( Holdinget al. 1977). These studies ranked the electoral wards of these cities according to their rates of suicide attempts and then correlated them with indices of social disorganisation. The studies consistently showed a strong association between high rates of deliberate self-harm and disorganised central city areas with overcrowding, lack of basic amenities, and an over-representation of social classes four and five. A very high percentage of social problems also characterised these wards, with marital disharmony, alcoholism, trouble with the law, juvenile delinquency, and cruelty to children.
In 1982, a similar study carried out in Cork ( Dalyet al. 1986) identified three distinct types of neighbourhood in which these non-fatal acts occurred most frequently. First, there were the local authority housing estates built some thirty years ago with the intention of rehousing slum dwellers. The children in these wards have grown to be adults, sometimes into single parents, sometimes married and living with their spouse and children in their parents' home. In consequence, there is serious overcrowd-