Global, Regional, and National Burden of Self-Harm and Projections to 2030: A Systematic Analysis for the Global Burden of Disease Study 2021.

BACKGROUND AND AIMS: Self-harm is a global public health problem, yet comprehensive analyses of its trends and the impact of sociodemographic factors remain insufficient. This study aimed to systematically examine the spatial and temporal trends of self-harm burden from 1990 to 2021 and forecast trends through 2030. METHODS: We analyzed data from the Global Burden of Disease Study 2021, examining age-standardized incidence, mortality, and disability-adjusted life years (DALYs) for self-harm by region, age, gender, and sociodemographic index (SDI) from 1990 to 2021. Attributable factors were assessed, with decomposition analysis identifying drivers of change and frontier analysis highlighting the minimum achievable burden relative to national development. Projections for 2030 were also estimated. RESULTS: In 2021, global age-standardized rates per 100,000 population were 67.89 (95% UI: 56.60, 80.76) for incidence, 8.99 (95% UI: 8.34, 9.64) for mortality, and 410.19 (95% UI: 383.38, 438.42) for DALYs. Alcohol use, drug use, and temperature-related exposures were associated with self-harm burden. In high, low-middle, and low SDI regions, increases in DALYs were driven predominantly by population growth. Higher-SDI settings showed greater potential for burden reduction relative to the estimated frontier. Projections suggest continued declines in mortality and DALY rates by 2030. CONCLUSION: This study enhances understanding of the evolving patterns of self-harm, providing evidence to inform policy and resource allocation. Continued progress may require implementing adaptable, evidence-based strategies that consider local healthcare and cultural contexts.