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Britain: dramatic increase in self-harm by children
By Liz Smith
23 September 2004
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A new report shows the rate of self-harm in Britain has increased
over the past decade and is among the highest in Europe.
The First Interim Inquiry Report into Young People and Self
Harm in the UK being conducted by the Mental Health Foundation
(MHF) and the Camelot Foundation is based on evidence submitted
by young people and parents/carers with experience of self-harm,
as well as professionals working in mental health, researchers
and academics, etc. The inquiry is ongoing so that those working
in the field of young peoples services may submit evidence
to further inform the inquiry over the next 18 months.
The interim report describes a wide range of things that people
do to themselves in a deliberate and usually hidden way that are
damaging, but focuses on three main areas:
* Cutting behaviours
* Other forms of self-harm (e.g., burning, scalding, banging,
hair pulling)
* Self-poisoning
It states, More than 24,000 teenagers are admitted to
hospital in the UK each year after deliberately harming themselves.
Most have taken overdoses or cut themselves. Additional figures
from the same study estimate that 1 in 10 teenagers self-harm.
The report makes clear that statistics on self-harm are unreliable
for a number of reasons:
Firstly, many incidents of self-harm will be treated
at home and will not reach the attention of services or professionals.
Secondly, the incidents that do reach [accident and emergency]
services are predominantly cases of self-poisoning and therefore
only account for a small sub-population of young people who self-harm.
Finally, figures on self-harm are confusing as the definitions
of self-harm used vary across the different research.
ChildLine, which provides a free, confidential, 24-hour telephone
helpline for any child or young person with a problem has also
just released its latest findings on self-harm.
Last year, 3,345 (3,032 girls, 313 boys) children and young
people talked to ChildLine about self-harming. Of these, 80 percent
talked about other problems in their lives. Forty percent spoke
about tensions within their familyfor example, separation
or divorce, or maltreatmentand 14 percent said they were
experiencing symptoms of depression or had other mental health
problems.
ChildLine also receives calls from children and adults who
are concerned about a young person they know. In 2002/2003, nearly
800 people (children and adults) contacted ChildLine because they
were worried about a child they suspected or knew to be self-harming.
Over the last 10 years, the number of children disclosing self-harm
to ChildLines counsellors has increased steadily, but has
dramatically increased by around 65 percent in the last two years.
The report points out that this increase can be attributed
in part to recognition of the problem, self-diagnosis by young
people and better identification. But even given this, there are
clear indications of worsening mental ill-health caused by the
pressures that young people face.
Since ChildLine was established, it normally hears from 4 times
as many girls as boys. However, the gender ratio shifts considerably
when self-harm is disclosed: 12 times as many girls as boys are
counselled about self-harm. The picture is similar when taking
into account those who contact ChildLine for their friends.
Of the 70 percent of those who disclosed their age to a counsellor
about all problems, a quarter were 5-11 years old, just over 60
percent were 12-15 years old, and the remaining 17 percent were
16-18 years old. Of the majority who talked about self-harm, 62
percent were aged 12-15 years old.
Cutting is the most common form of self-harm disclosed by young
people calling ChildLine. In the personal testimonies given, two
main themes emerged. Callers often disclose anger and frustration
at their situation, with self-harm providing their only outlet
for this emotion. As with other mental health problems (e.g.,
eating disorders, depression, and suicidal thoughts), children
who self-harm also talk about a loss of control over their lives,
and state that by inflicting injury and pain on their bodies they
gain a sense of control and personal ownership. Callers often
disclose a trigger or circumstance that led them to
begin self-harming. In some cases this is prompted by bullying,
or other incidences connected to education or schooling.
But the majority of callers raise family relationships as their
main trigger. Experiences such as pressure from parents to do
well in exams and marital breakdowns were cited as some of the
reasons given to counsellors. Others spoke about grief, family
crises and sexual abuse.
Some of the young people acknowledged their parents were aware
of the cutting. But the young people who are self-harming not
only see this as a coping mechanism, but as an alternative to
seeking support and advice from professionals. This aspect was
highlighted by Dr. Carole Easton, chief executive of ChildLine,
who said, The experiences of ChildLines callers highlight
the need for directly accessible, widely available and well-resourced
child and adolescent mental health services.
The report makes clear that the trigger factors alone should
be seen in context, because clearly not all teenagers deal with
pressures in the same way. Based on previous reports the initial
inquiry shows that young people who self-harm are more likely
to come from certain sub-populations that have a much higher
likelihood of having direct experience of self-harm compared to
the general population. For example:
* Young women, who are three to four times more likely to self-harm
than young men
* Young people in prisons, in particular young women
* Young Asian females
* Individuals in other institutional settings such as inpatient
psychiatric units.
Within all of the literature previewed, only one paper specifically
investigates self-harm within the inquirys age range of
11-25 years. The vast majority of the literature spans late adolescence
through to middle adulthood (i.e., 16+ years).
The report cautions that whilst there has been an expansion
in Child and Adolescent Mental Health Services in recent years,
there has also been an increase in the voluntary sector and the
use of untrained staff. It warns that there is a tendency
to believe that any kind of counselling/therapy, even from an
untrained worker, is better than none. For talking therapies
to be beneficial to the young people with experience of self-harm
it must be carried out by appropriately trained staff, and must
be focused on the problems or issues that the young people want
to address. There is a need for staff to be knowledgeable and
trained in the issues around self-harm specifically and to be
engaged with the young person about what else is going on in their
lives when addressing their self-harming behaviour.
Additionally, the report points out that if the young person
attends hospital, which they do only if they need treatment, the
majority of interventions are carried out from a medical and not
a psychosocial standpoint.
Thus far, the young people who have submitted evidence to the
inquiry have spoken about the negative experiences when they engaged
with services for support.
See Also:
Britain: Teenagers driven to
depression and suicide by exam pressures
[25 June 2004]
Britain: Sharp rise in arson
attacks on schools
[7 May 2004]
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