There has been a sharp rise in self-harm reported in general practices for girls aged between 13-16 years from 2011 to 2014, compared with boys of the same age. In socially deprived areas, referrals to mental health specialist services were fewer, although self-harm rates were higher, finds a study published by The BMJ
Self-harm in children and adolescents is a major public health problem in many countries. It is the strongest risk factor for subsequent suicide, with suicide being the second most common cause of death before reaching the age of 25 worldwide.
Lead researcher, Dr Cathy Morgan at The University of Manchester, and the team set out to investigate trends in self-harm amongst children and teenagers in the UK, referral rates to specialist mental health services, and mortality rates amongst children and teenagers following self-harm. Unlike most previous studies, the researchers examined self-harm recorded in general practice rather than hospital settings.
To estimate rates of self-harm, they analysed data for 16,912 patients aged between 10-19 years from 674 general practices, who harmed themselves during 2001 to 2014. To assess mortality, they compared data from 8,638 of these patients with 170,274 unaffected children (matched by age, gender and general practice).
They found that the rate of self-harm recorded in general practice was higher in girls (37.4 per 10,000) compared with boys (12.3 per 10,000), and rose by 68% in girls aged 13 to 16, from 45.9 per 10,000 in 2011 to 77.0 per 10,000 in 2014.
Referrals to specialist mental health services within 12 months of self-harming were 23% less likely for young patients registered in practices in the most deprived areas even though the rates of self-harm were higher in these areas.
Children and teenagers who self-harmed were nine times more likely to die unnaturally than unaffected children, with an especially marked increased risk of suicide and acute alcohol/drug poisoning death. “This emphasises the opportunity for earlier intervention in primary care to reduce suicide risk” say the authors.