Monday, 10 October 2016

Adolescent self-harm: Summary of our publication in the International Journal of Public Health

Self-harm can be defined as the act of deliberately causing harm to oneself, and may include a number of behaviours such as cutting, burning, hitting, scratching and self-poisoning1. The behaviour is thought to be most common among teenagers2, and self-harming during adolescence has been associated with an increased risk of mental health problems in adulthood3.

Questions on self-harm were added to the HBSC England survey for the first time in 2014, motivated by reports poor emotional wellbeing and self-harm were on the increase among young people4,5. Furthermore, a review conducted in 2013 by the Association for Young People’s Health (AYPH) identified a lack of research on young people who self-harm but do not attend hospital with their injuries6. We have blogged previously about the motivation to include the topic of self-harm in the HBSC England survey, for further details have a read of our blog post here

Analysis of the 2014 HBSC England data identified around a fifth (21.5%) of 15 year old respondents reported having self-harmed (data published previously in articles by the Guardian and BBC). Fifteen year old girls were nearly three times as likely as boys to report having self-harmed; 31.9% of girls compared with 11.4% of boys. Figure 1 illustrates how often young people were self-harming; the majority of those who self-harmed reported self-harming around once a month.

Note: Figure 1 originates from Brooks et al. (2015)

Given that this is the first time self-harm has been added to the HBSC England survey our data alone cannot tell us whether self-harm has changed over time. However, comparing our data to a similar school based study conducted in England during 2000/017 suggests self-harm rates may have nearly tripled over the past decade. Questions on self-harm will be included in the HBSC England survey during the next round, allowing us to observe any changes between 2014 and 2018. 

While it was important to gain new insight into prevalence rates of self-harm, particularly for those young people who do not present at hospital with their injuries, the HBSC study also allows us to examine the relationship between self-harm and different elements of young people’s lives.

Our recent article sought to identify factors from the family, school and community which may help protect young people against self-harming. The study utilised data from a total of 1519 15 year olds who participated in the 2014 HBSC England survey. Self-harm was measured via the question “Have you ever deliberately hurt yourself in some way, such as cut or hit yourself on purpose or taken an overdose?”

The analysis identified key elements which were associated with self-harming including gender, family communication and a positive perception of the school and neighbourhood environments. In line with existing research6, the analysis identified girls were at a greater risk of self-harming compared to boys. The paper highlights the important role parents may play in preventing self-harm, as young people who found it difficult to talk to their mother and father had a greater chance of reporting self-harm than those who described family communication as easy.

For a more thorough discussion of our latest findings the full paper can be found by clicking here. The International Journal of Public Health have also created a useful visual summary of this paper which you can access here


1. National Self Harm Network. What is self harm? NSHM. Retrieved October, 5, 2016 from

2. Hawton, K., Saunders, K. & O’Connor, R, (2012). Self-harm and suicide in adolescents. The Lancet, 379, 2373-82.

3. Kidger, J., Heron, J., Lewis, G., Evans, J. & Gunnel, D. (2012). Adolescent self-harm and suicidal thoughts in the ALSPAC cohort: a self-report survey in England. BMC Psyhiatry, 12, 69.

4. Collishaw, S., Maughan, B., Goodman, R. & Pickles, A. (2004). Time trends in adolescent mental health. Journal of Child Psychology and Psychiatry, 45(8), 1350-62.

6. Hagell, A. (2013). Adolescent self-harm: AYPH Research Summary No. 13. Association for Young People's Health (AYPH) & ChiMat.

7. Hawton, K., Rodham, K., Evans, E., & Weatherall, R. (2002). Deliberate self-harm in adolescents: self-report survey in schools in England. BMJ, 325, 1207–11

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