Over the last year or so, we have seen an unprecedented groundswell of media interest in the field of mental health as reports of a crisis in the mental health of the nation, particularly amongst young people, has struck a chord. Along with this has come increased public awareness of the complex nature of mental health, and acceptance of mental health issues as 'legitimate'. Although we have a long road to travel, we have made incredible progress in the last year.
Unfortunately, the rising tide of mental health issues seems to lift all boats, and self-harm is no exception. Recently, new figures from the NHS confirmed that the number of young people self-harming has seen a dramatic rise in the past ten years. The number of girls under the age of 18 who have been admitted to hospital after poisoning themselves has shot up from 9,741 in 2005-06 to 13,853 in 2014-15. In this same decade, hospitals have witnessed a 385% rise in self-harm cutting related injuries.
Clearly something significant is happening in the lives of young women today, a society wide trend we can only theorise about. We don't know as much about self-harm as a phenomenon as we would like to. The term covers a very wide range of behaviours, most often cutting but can also include scratching and head banging. This can make it difficult to define and classify the problem. Psychological ailments pass in and out of prevalence over time, but self-harm seems to have become a disorder of the moment with around 10% of young people self-harming depending on age and gender. Actual rates of self-harm are very difficult to quantify, as the behaviour is secretive in nature and very few adolescents will ever be brought to the attention of our health services.
So what is to be done? More research must be carried out into why exactly we are seeing such a dramatic rise in self-harm amongst teenagers and young people, and the real rate of prevalence amongst young people. Is it to do with increased educational pressures, social media, the prolongation of 'childhood' with increased responsibility but probably decreased authority for decision making about their own lives?
We know that bullying, including being bullied by siblings at home contributes; indirect, more subtle forms of victimisation are also associated with self-harm as are anxiety and loneliness. It seems that the life circumstances of young people are critical. Do we give them enough support to deal with large schools? Do we spend as much time with them as we should? Do we supervise them closely enough to make sure they are adequately protected? We do not know enough!
Perhaps more importantly, the most effective treatments for self-harm need to be urgently identified, and best practice rolled out across the NHS - notwithstanding challenges posed by long waiting lists and services under pressure.
In the meantime, as mental health professionals we can continue to educate ourselves and exchange knowledge to advocate for change. If you're interested in the phenomenon of self-harm, the latest research and those with first-hand experience of self-harm, you can listen to the Anna Freud National Centre for Children and Families'podcast on the subject.
The rise of self-harm indicates a certain kind of crisis amongst young people today, for reasons only speculated on in column inches. Yet we have no firm scientific evidence on why exactly we are seeing this phenomenon. We urgently need more research on the reasons behind this epidemic. Funding, evidence-based treatments and true partnership-working with patients are needed if we are to face these issues and do right by our patients, particularly our young women. Doing nothing is no longer an option.