New research identifies time away from school, ADHD and autism as significant risk factors in self-harm among 11 to 17 year olds.
The research examined data from 113,000 young people and used data linkage – bringing sources of information related to the same individual together – to identify risk factors.
Combining information, such as school attendance, special educational needs and free school meal status with hospital data, the researchers wanted to examine the association of self-harm – which they defined as “any act of self-poisoning or self-injury carried out by an individual regardless of motivation” – with socio-demographic, economic, health and educational risk factors. They also wanted to test the hypothesis that autism spectrum disorder (ASD) is associated with increased risk of self-harm during adolescence.
Eighteen per cent (almost one in five) of adolescents in the UK report having self-harmed before the age of 18 – and one in eight self-harm episodes in teenagers are seen in hospital emergency departments. However, presentations to hospitals with self-harm have been shown to be one of the strongest risk factors for future suicide – a study of serious case reviews found that some ten to 20 per cent of young people who die by suicide in the UK visit a hospital for self-harm in the year prior to their death. In this context, the researchers from the University of Bristol and King’s College London wanted to identify risks factors as an important step towards developing early recognition and prevention programmes.
Their study found that the risk of self-harm was nearly three times higher for boys with autism spectrum disorder (ASD) compared to those without ASD, but ASD wasn’t a significant risk factor for self-harm among girls (although they acknowledged that this may be due to underdiagnosis of ASD in girls). In line with previous research, their study also showed that the risk of self-harm was higher in girls (1.5 per cent) than in boys (0.3 per cent) generally.
However, among both boys and girls, attention deficit hyperactivity disorder (ADHD) was a strong predictor of self-harm – and young people with ADHD were approximately four times more likely to self-harm than those without the condition. Meanwhile adolescents who had previously got help with mental health services for ADHD were at four times greater risk of self-harm than those who had not attended services for ADHD.
The researchers also found for teens with less than 80 per cent attendance at school, the risk of self-harm was three times greater than for those with 80 per cent-plus attendance. “These findings do not show that school absence causes self-harm,” emphasised the researchers. “They do, however, suggest that this is an important group of young people at whom to target preventative interventions.”
The study concluded that its findings were “an important step in the development of strategies to prevent self-harm through the identification of vulnerable groups" and a good “example of how routinely collected public service data linkage can be used to tackle important public health issues.”
If you are struggling with your mental health, you can find local sources of support on this website.
West Sussex Mind is part of the self-harm learning network, which offers free courses and resources for parents and carers and secondary school staff to help them understand and respond to young people who may be self-harming.