80% of children who self-harm act ‘impulsively’

THE vast majority of children who have deliberately self-harmed did so “impulsively” and after an argument at home, at school or with peers, according to a major 11-year study.

The research said that of 231 children who self- harmed, half had intended to kill themselves. The average age was 13, with ages ranging from as young as six to 17.

Authors said deliberate self-harm (DSH) was a “significant public health problem” in young people here and that rates continue to rise.

They said the recession had also “added significant stress” on the family.

The report said the necessary services were “inadequate and outdated” in many parts of the country and said youth-friendly services, the internet and schools should be used to reach out to those self- harming.

The study was conducted by the Department of Child and Adolescent Psychiatry at Crumlin Children’s Hospital and involved a retrospective examination of case notes of all children who presented with DSH between 1993 and 2003.

Of the 197 cases where charts were present, 146 (74%) were female and 51 (26%) were male.

Some 72% of children indicated they had academic concerns, such as requiring extra help or stressful exam pressure.

The research showed that in 80% of cases the self- harming was an “impulsive act”.

The vast majority (78%) harmed themselves at home and were alone but many of these spontaneously revealed the harm to another person.

The report, published in the Irish Journal of Psychological Medicine, said more than half said they were in low mood at the time of the harming, while almost a third said they were angry. Some 9% said they had consumed alcohol.

In the vast majority of cases (81%) children had ingested tablets, most commonly paracetemol. A further 8% had used violent methods such as hanging or jumping from a height, while 4% had cut themselves.

Lead author, Fiona McNicholas, consultant child and adolescent psychiatrist, said only a small minority had previously been engaged with mental health services.

The report said alcohol was a risk factor and where present increased the risk of DSH eight-fold: “Alcohol consumption has frequently been linked to impulsivity and it is of note that clinicians in this study rated 80% of presentations as being impulsive.”

It noted that a major risk factor included a recent stressful event, such as an “emotionally charged or explosive confrontation with a parent”.

The report said the majority of children were living with both parents and attending secondary school. Around 10% were either in the care of social services or had social worker involvement.

It said 15% had a family history of DSH and that 18% had a history of abuse, most commonly child sexual abuse.

* For help contact:

Headstrong — 01 472 7010 or headstrong.ie

Childline — 1800 666 666 or ispcc.ie

Samaritans — 1850 60 90 90 or samaritans.org

The reasons

Conflict experienced before self-harming:

* 89% of children experienced a “stressful life event” beforehand.

* 48% said they had clashed with their parents or other family member.

* 11% said there had been conflict in school.

* 9% said they had clashed with peers.