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
  • hitting or scratching
  • breaking bones
  • hair pulling
  • swallowing toxic substances or objects.
Although some very young children and some adults are known to self-harm and it often continues from childhood into adulthood, the majority of people who self-harm are aged between 11 and 25 years.

Why do young people self-harm?

Self-harm is a symptom of underlying mental or emotional distress. Young people who self-harm mainly do so because they find it helps relieve distressing feelings and helps them cope with problems in their lives. It is rarely about trying to end their life.
A wide range of factors may be involved. Very often there are multiple triggers, or 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.

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 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.
It is estimated 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.

Can self-harm among young people be prevented?

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 well-being 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 suggests 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.

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.

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.