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Foundation for People with Learning Disabilities
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Self-harm

Self-harm among young people is a major public health issue in the UK. It affects at least 1 in 15 young people, blights the lives of young people and seriously affects their relationships with families and friends. It presents a major challenge to all those in services and organisations that work with young people, from schools through to hospital accident and emergency departments.

 

What is self-harm?

 

Self-harm describes a wide range of things that people do to themselves in a deliberate and usually hidden way. In the vast majority of cases self-harm remains a secretive behaviour that can go on for a long time without being discovered. Self-harm can involve:

 

  • cutting
  • burning
  • scalding
  • banging or scratching one’s own body
  • breaking bones
  • hair pulling
  • ingesting toxic substances or objects

 

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Why is self-harm an issue for young people?

 

Although some very young children are known to self-harm and some adults too, the available research evidence indicates that average age of onset is 12 years old. The evidence also shows that the rates of self-harm in adults aged 25 years and over are relatively low, so that the majority of young people who self-harm are aged between 11 and 25 years.

 

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Why do young people self-harm?

 

It is important to recognise that self-harm is a symptom of underlying mental or emotional distress. Young people who self-harm mainly do so because they have no other way of coping with problems in their lives. The evidence about the reasons why young people self-harm shows that there are a wide range of factors that might contribute. Very often it appears – based on evidence from young people themselves – there may be multiple triggers, often daily stresses, rather than one significant change or event. Factors can include:

 

  • feeling isolated
  • academic pressures
  • suicide or self-harm by someone close to the young person
  • family problems, including parental separation or divorce
  • being bullied
  • low self-esteem

 

But self-harm is not a good way of dealing with such problems. It provides only temporary relief and does not deal with the underlying issues.

 

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How common is self-harm among young people?

 

There is relatively little research evidence about the prevalence of self-harm among young people. Hospital records show that some 142,000 young people present at accident and emergency departments each year as a result of their self-harm but this is only part of the picture. The majority of young people who self-harm will either not harm themselves in a way that needs medical treatment or they will deal with it themselves.

 

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Related Information

The research evidence that is available shows that between 1 in 12 and 1 in 15 young people self-harm in the UK. Some research suggests that the UK has the highest rate of self-harm in Europe.

 

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Can self-harm among young people be prevented?

 

There is increasing evidence showing that there are ways to prevent self-harm among young people. Anti-bullying strategies and whole-school approaches designed to improve the general mental health and wellbeing of young people appear to have a positive effect, though there is no specific evidence as yet on their impact on self-harm.

 

Evidence from young people themselves suggest that social isolation – and believing that they are the only one that has self-harmed - can be a key factor in self-harm for some. It is likely that better information for young people about self-harm would increase their understanding and might help reduce or prevent self-harm. Similarly, better awareness and understanding among parents, teachers and others who come into contact with young people is also likely to have a positive impact.

 

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Do we have good responses to young people who self-harm?

 

There are a wide range of services across the UK for young people who self-harm. Anecdotal evidence suggests that many young people benefit very much from these, but to date there is not a strong evidence base to demonstrate their effectiveness.

 

There is stronger evidence – mostly direct from young people – that finding ways to distract from, or alternatives to, self-harm can be very important for many young people. Distraction techniques that are reported as being effective for some young people include using a red pen to mark rather than cutting, rubbing with ice, hitting a punch bag or flicking elastic bands on the wrist.

 

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Conclusion

 

Self-harm among young people is a serious public health challenge. There is a need for much better data about prevalence. There is also a need for better awareness and understanding of self-harm and its underlying causes both among young people themselves and those who come into contact with them. Stronger and clearer evidence about what might prevent self-harm and about effective responses to self-harm among young people is also needed.

 

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Written in 2006

 

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