Have public health responses to COVID-19 considered social inequalities in health ? : insights from Brazil, Canada, France and Mali [résumé] Gagnon-Dufresne, M.C. Gautier, L. Beaujoin, C. Richard, Z. Boivin, P. Medeiros, S. /Ridde, Valéry Zinszer, K. Background: Research has indicated an increased risk of self-harm repetition and suicide among individuals with frequent self-harm episodes. Co-occurring physical and mental illness further increases the risk of self-harm and suicide. However, the association between this co-occurrence and frequent self-harm episodes is not well understood. We examined the profile of individuals with frequent self-harm episodes and the association between physical and mental illness comorbidity, self-harm repetition and highly lethal self-harm acts. Methods: The study included consecutive patients with five or more self-harm presentations to Emergency Departments across three general hospitals in the Republic of Ireland. The study included file reviews (n=183) and semi-structured interviews (n=36). Multivariate logistic regression models were used to test the association between the sociodemographic and the comorbidity variables on highly lethal self-harm acts. Thematic analysis was applied to identify themes related to the comorbidity and frequent self-harm repetition. Findings: Most of the participants were female (59.6%), single (56.1%) and unemployed (57.4%). The predominant current self-harm method was drug overdose (60%). Almost 90 % of the participants had history of a mental or behavioural disorder, and 56.8% had recent physical illness. The most common psychiatric diagnoses were alcohol use disorders (51.1%), borderline personality disorder (44.0%), and major depressive disorder (37.8%). Male gender (OR=2.89) and alcohol abuse (OR=2.64) were associated with highly lethal self-harm acts. Major qualitative themes were a) the functional meaning of self-harm b) self-harm comorbidity c) family psychiatric history and d) contacts with mental health services. Participants described experiencing an uncontrollable self-harm urge, and self-harm was referred to as a way to get relief from emotional pain or self- punishment to cope with anger and stressors. Conclusions: Physical and mental illness comorbidity was high among the participants. The mental and physical illness comorbidity of these patients should be addressed via a biopsychosocial assessment and subsequent interventions. 2023 text https://www.documentation.ird.fr/hor/fdi:010095773 fdi:010095773 Gagnon-Dufresne M.C., Gautier L., Beaujoin C., Richard Z., Boivin P., Medeiros S., Ridde Valéry, Zinszer K.. Have public health responses to COVID-19 considered social inequalities in health ? : insights from Brazil, Canada, France and Mali [résumé]. 2023, 5 (Suppl.), A366 (1 ) World Congress on Public Health, 17., Rome (ITA), 2023/05/02-06 EN IRLANDE FRANCE BRESIL MALI CANADA