Understanding self-harm in children and young people
Between September 2021 – March 2022, Fullscope undertook desktop research and data analysis of the prevalence of self-harm in Cambridgeshire and Peterborough. The works comes under the wider Wave 4 suicide prevention work of Cambridgeshire and Peterborough Public Health, funded by the CCG.
Our resulting report demonstrates what we have found beyond the reported hospital rates. Public Health data shows us that the number of young people between the ages of 10 – 25 attending Cambridgeshire hospitals for self-injurious behaviour, and subsequent admittance, are amongst the highest in England. Rates of self-harm across England generally are extremely high and rising, however the known rates presenting to services represents the tip of the iceberg: the prevalence rate for ever having self-harmed for under 25s is somewhere around 20% of all young people.
We have sought to understand the wider picture within the local area, beyond the known rates for hospitals. Working with statutory and voluntary sector services, we collected data and case studies around young people presenting with self-harm. The data we collected, however, was not enough to provide analysable comparisons to create an average for local prevalence. For young people presenting to voluntary sector and statutory services, reported rates for self-harm as the presenting need ranged somewhere between 3.8% - 60%. Differences in definitions, along with the ways in which young people are asked about self-harm, or not, and the ways in which self-harm data is collected, account somewhat for this wide variance. Identifying this gap has been important: we now know what we don’t know, and have made recommendations based on this.
National research, for example, shows that rates of self-harm are much higher amongst adolescent girls, LGBTQ+ young people, young people with autism, ethnic minority females, and those from communities with the highest levels of socio-economic deprivation. A clearer consistency around data collection and analysis across services might allow for a greater understanding of the issues amongst these groups locally, and also support targeted interventions.
We also know that rates amongst boys may be misrepresented due to gaps in understanding of the ways in which boys might present with self-harming bahaviours; dysregulation may present differently in terms of aggressive behaviours, excessive use of alcohol or other substances, or other risk-taking activities.
The strand of work that Fullscope is undertaking within the wider Wave 4 programme is important because it is known that whilst not all young people who self-harm do so with suicidal intent, over half of those who go on to die by suicide will have a history of self-harm. Young people who self-harm should always be taken seriously.
Alongside this data and research strand of work, Fullscope has been working with local young people and their families to understand the issues around self-harm from their own unique perspective, working together to co-design a response grounded in lived experience. A further report on this work will follow this summer, along with a proposal to Public Health for a new self-harm pilot project based on our co-production work.
For further information or to get involved, contact katie@fullscopecollaboration.org.uk