Self-harm among young people is on the rise, with potentially devastating consequences. Karen Sullivan looks at the statistics and suggests what role schools can play to tackle this danger

There can be few acts perpetrated by adolescents (or, indeed, anyone else) that are as distressing as self-harm, and yet, fed by an increasing sense of isolation and desperation and the wealth of inflammatory material on the internet (leading, of course, to it seeming almost “trendy”), it is becoming a serious, growing problem that shows no signs of abating.

It’s one of the top five causes of hospital admissions in the UK, and it is also associated with depression, sleep problems, psychological distress and suicidal risk, according to a number of studies (including Burton, 2014 & Kidger et al, 2012).

One recent study, Self-harm in Adolescence: Protective health assets in the family, school and community (Klemera et al, 2016) suggests that self-harm becomes increasingly common between 12 and 15 years of age, with more girls than boys at risk.

However, this pattern seems to change with age, with the later teenage years reversing that trend. One of the outcomes of the research is confirmation that “connections with others and a sense of belonging” is significant for adolescent health and wellbeing, and in particular apart from parent relationships, young people’s sense of belonging and connectedness to school and the wider neighbourhood appears to be a “strong health asset protecting from self-harm”.

Evidence from the Health Behaviour in School-Aged Children (HBSC) study team at the University of Hertfordshire states that “educational settings play a crucial role in promoting wellbeing in young people and preventing the development of mental health problems”. Their findings, published in the International Journal of Public Health, suggest that young people are nearly seven times more likely to self-harm if they have a low sense of belonging to school, than those who feel attached to it.

They point to the latest HBSC study in England, which reveals that 11 per cent of boys and 32 per cent of girls aged 15 report that they have self-harmed, with
43 per cent claiming to do so once a month. The HBSC study team concludes that focusing on early prevention and intervention can make a difference. They emphasise the importance of education providers “embedding a positive ethos and culture of community within schools as a means to tackle the growing problem”.

One of the most obvious solutions, they go on to say, is to use PSHE education to promote good health. Their research suggest that 74 per cent of young people who attended PSHE lessons (boys and girls) felt that they helped them to look after their own health (and improved their skills and abilities to consider the importance of their own health).

Most importantly, however, further analysis of the HBSC England study found that young people with positive perceptions of the PSHE lessons they received were “more likely to report good relationships at school and a feeling of school belonging”.

PSHE is not (yet) a statutory curriculum subject, but given the clear link between stronger emotional health and its potential to reduce self-harm (many harmers consider it to be a “coping mechanism”), this is something that should be considered.

If you’ve timetabled PSHE lessons, it seems obvious not only that self-harm should be covered, but that mental health and dealing with stress and feelings of worthlessness and despair need to be addressed too; that a spirit of support and connection is engendered in these classes and across the school as a whole. If PSHE is not in the curriculum at your school, time should be made, in form periods or elsewhere, to draw attention to this problem. And why?

Recent evidence shows a 70 per cent increase in 10 to 14-year-olds attending A&E for self-harm-related reasons between 2012 and 2014 and, in fact, according to NHS England data, between 2006 and 2016, the number of girls under-18 who have required hospital treatment after poisoning themselves has increased from 9,741 to 13,853 (a figure unchanged in boys). Furthermore, the number of girls treated as inpatients after cutting themselves almost quadrupled, from 600 to 2,311 cases across the same period.

According to Self Harm UK, the act can cause changes in brain chemistry, which can easily become addictive. They suggest that people who self-harm do not normally wish to kill themselves, but choose it as a way of coping with life and being “able to continue living despite the emotional difficulties they may be experiencing”. More devastatingly, they add: “For some, the physical pain of self-harm reassures them that they are still alive ... because they are experiencing emotional numbness or feeling disconnected from the world around them.”

It is worth noting here, too, that self-harm is the single biggest cause of death in people between the ages of 20 to 24 in the UK (The Lancet Commission, 2016), suggesting that it is an on-going problem that can snowball if left unchecked.

In my next article (due to publish on September 28), we’ll look at ways to increase support and feeling of belonging within the school community, and to raise awareness of the very real dangers of self-harm in both the short and long-term. In the meantime, make a point of starting the conversation before it’s too late.SecEd

  • Karen Sullivan is a best-selling author, psychologist and childcare expert. Email kesullivan@aol.com. To read her previous articles for SecEd, including in this series, go to http://bit.ly/1SNgg00

Further information