This systematic review by David Owens, Judith Horrocks, and Allan House examines the rates of fatal and non-fatal repetition of self-harm. The study aims to quantify these outcomes to inform the development and testing of effective interventions. The review includes 90 studies from observational and experimental studies, with a median follow-up period of one year. Key findings include: - **Non-fatal Repetition**: 16% of patients repeat non-fatal self-harm within one year, increasing to 23% over longer follow-up periods. - **Fatal Repetition**: The risk of subsequent suicide is between 0.5% and 2% within one year and rises to over 5% after nine years. - **UK Studies**: UK studies show particularly low rates of subsequent suicide, with a median of nearly five times lower than other studies. The review highlights the strong connection between self-harm and later suicide, emphasizing the need for better understanding and intervention to reduce this risk. The study also notes limitations, such as the reliance on small studies and poor follow-up data, which affect the precision of estimates.This systematic review by David Owens, Judith Horrocks, and Allan House examines the rates of fatal and non-fatal repetition of self-harm. The study aims to quantify these outcomes to inform the development and testing of effective interventions. The review includes 90 studies from observational and experimental studies, with a median follow-up period of one year. Key findings include: - **Non-fatal Repetition**: 16% of patients repeat non-fatal self-harm within one year, increasing to 23% over longer follow-up periods. - **Fatal Repetition**: The risk of subsequent suicide is between 0.5% and 2% within one year and rises to over 5% after nine years. - **UK Studies**: UK studies show particularly low rates of subsequent suicide, with a median of nearly five times lower than other studies. The review highlights the strong connection between self-harm and later suicide, emphasizing the need for better understanding and intervention to reduce this risk. The study also notes limitations, such as the reliance on small studies and poor follow-up data, which affect the precision of estimates.