A study published this week (Trafford et al, 2023) analyses around nine million GP records of young people aged from 10 to 24 over a period of 12 years from 2010.
It finds that since March 2020, eating disorders were higher than would have been expected based on previous trends. For young women aged 13 to 16, they were up 42%; for those aged 17 to 19 they were up 32%.
The increase in levels of self-harm was also greatest among females aged 13 to 16, with the number of episodes being 38% greater than expected.
In contrast, researchers found no evidence of an increase in levels of self-harm in females in the other age groups and no increase in rates of eating disorders or self-harm was seen in young men.
The study has been conducted jointly by the University of Manchester, Keele University, University of Exeter, and mental health research charity The McPin Foundation, and has been published in the Lancet Child and Adolescent Health.
It was conducted using a database of anonymised primary care electronic health records of more than nine million patients aged 10 to 24 from 1,881 general practices in the UK.
The study says that self-harm and eating disorders, as well as being major health issues in their own right, are coping mechanisms that are often indicative of underlying psychological distress, and they share multiple risk factors.
Last year, NHS research found that almost one in five children aged 7 to 16 (18%) as well as one in four young people aged 17 to 19 (25.7%) have a probable mental health disorder.
The Mental Health of Children and Young People in England 2022 study (Newlove-Delgado et al, 2022) also raised particular concerns about eating disorders and self-harm.
Mental health levels are notably higher than in 2017, when the NHS study was first carried out and when 10.1% of 17 to 19-year-olds and 12.1% of seven to 16-year-olds had probable mental health conditions.
When it came to eating disorders, the NHS report found that 12.9% of 11 to 16-year-olds and 60.3% of 17 to 19-year-olds had a possible eating problem. Across all age groups, the rate of possible eating problems was notably higher in girls than boys.
And for self-harm, the NHS report warned that those with a probable mental disorder were more likely to report self-harm: 28.3% of 7 to 16-year-olds and 68.6% of 17 to 24-year-olds with a probable mental disorder had ever tried to harm themselves. Of those unlikely to have a mental disorder, these figures are 2.5% and 17.8% respectively.
The new study found that for the 10-year period before the pandemic, diagnoses of eating disorders in females were more common in those from more affluent backgrounds. This gap has now widened.
Since March 2020, eating disorder diagnoses for females living in the least deprived communities were 52% higher than expected, compared with 22% higher for those living in the most deprived areas.
Conversely, rates of self-harm were higher in the most deprived areas and this gap has narrowed since March 2020.
Lead author Dr Pearl Mok from the University of Manchester said the reasons for the increased rates of eating disorder and self-harm were likely to be complex and could be due to a mixture of issues, including social isolation, anxiety, disruption in education, unhealthy social media influences, and increased clinical awareness.
She continued: “Our study is large, but episodes of self-harm that were not treated by health services were not captured in our data, so the rise in self-harm incidence might have been even greater than we observed.”
Dr Shruti Garg, child and adolescent psychiatrist and co-investigator from the University of Manchester, added: “The staggering rise in eating disorder diagnoses and self-harm episodes among teenage females highlights an urgent need to improve early access to services and for timely intervention.”
Prof Carolyn Chew-Graham, academic GP and co-investigator from Keele University, said: “Early identification of mental health difficulties in children and young people by primary care clinicians is extremely important as this facilitates timely access to treatments. Sufficient support, however, from GPs and mental health services needs to be available to manage those presenting.
“Given the current pressures on the NHS, in both primary and specialist care, our study emphasises the need for sufficient capacity in mental health services to meet growing demand.”
In May, SecEd reported frustration at the slow roll-out of the government’s Mental Health Support Team initiative. Only a third of pupils are currently covered by one of these new teams, which are intended to support the mental health needs of children and young people in primary, secondary, and further education (ages 5 to 18), providing early intervention on issues such as mild to moderate anxiety. Delivery is led by the NHS with support from the DfE.
- Newlove-Delgado et al: Mental Health of Children and Young People in England 2022, NHS Digital, November 2022: http://bit.ly/3AX0zTC
- Trafford et al: Temporal trends in eating disorder and self-harm incidence rates among adolescents and young adults in the UK in the two years following onset of the COVID-19 pandemic: a population-based study, Lancet Child and Adolescent Health, June 2023: https://bit.ly/44b5Inb