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Report highlights increase in self-harm

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RCPsych release self-harm study

A new report on the provision of care for those who self-harm has just been released by the Royal College of Psychiatrists (RCPsych).

More than 1,500 mental health professionals were interviewed for the report, which is entitled Self-Harm, Suicide and Risk: Helping People who Self-Harm.

One of the key findings of the study was that incidences of self-harm have increased among the general population during the past 20 years.

The report estimates that around one in four people have self-harmed and finds that the rate of self-harm among young people in the UK is one of the highest in Europe.

Joe Ferns, director of policy at Samaritans and a member of the report's working group, said: "This report is a timely reminder that good care for people at risk of self-harm and suicide can lead to a reduction in the nation's suicide rate."

He added recent suicide statistics for the Republic of Ireland have seen an increase in suicides for 2009 by 24 per cent compared to the previous year, highlighting the need for the UK government to commit to a comprehensive suicide prevention strategy.

NHS Recommendations

The RCPsych report expresses concern that some people who self-harm may not be getting the support they need due to an inconsistent level of support across the National Health Service.

It states that inexperienced junior doctors are often left in charge of patients who have self-harmed, particularly within accident and emergency departments.

Of the psychiatrists surveyed, less than half felt they or their team had received sufficient training to enable them to assess the needs of someone showing symptoms of self-harm.

Lord John Alderdice, chair of the working group responsible for the report, said: "When a person turns up to hospital having harmed themselves, this may well be the first time they have had contact with the health service.

"Failure to deal effectively with a person at this stage can have major repercussions."

He added that if cases of self-harm are not properly assessed, patients may be discouraged from returning to healthcare services to seek support in the future.

The report makes a series of recommendations which it claims will improve the quality of NHS care provision.

One key suggestion is for all patients who arrive at accident and emergency departments with suspected self-inflicted injuries to be given access to fully-trained clinical staff.

Further recommendations include increasing the amount of training provided to NHS staff on issues relating to self-harm and the development of a public health strategy.

Definitions of self-harm

Within the UK and Europe there is a preference to use the words 'deliberate self-harm' and 'intentional self-harm' to distinguish self-harm from accidental harm.

However, concerns have been expressed that these labels may be patronising to people who self-harm, as they do not reflect the lack of control and addiction that some people experience (Platt et al 1997).

Depression, feeling alone and negative thoughts towards oneself are common emotions among young people who self-harm.

Reasons why people self-harm are quite complex and difficult to categorise although the practice can generally be divided into two categories, known as 'cry of pain', and 'cry of help'.

Those who self harm as a cry of pain can be seeking relief for emotional distress, experiencing suicidal thoughts or attempting to punish themselves (Hawton et al in 2006).

People who self-harm as a cry of help can be trying to gain attention, expressing desperation or attempting to frighten someone (Scoliers et al in 2009). However, the term 'cry of help' can be problematic because help may not be accepted by, or feel like a real option for, people who self-harm.

A Samaritans survey conducted between 2006 and 2007 found that 39 per cent of service users who completed an online questionnaire listed self-harm as their primary reason for contacting the organisation.

A further 67 per cent of these respondents found that discussing their feelings with Samaritans volunteers reduced their desire to self-harm.

Samaritans

Samaritans is available nationwide to anyone experiencing emotional distress or suicidal thoughts. They can be called for support 24 hours a day on 08457 90 90 90 (UK) and 1850 60 90 90 (ROI), or emailed at jo@samaritans.org. Face to face visits are also available – visit http://www.samaritans.org/ for the nearest branch.

Sources

http://www.rcpsych.ac.uk/press/pressreleases2010/selfharmsuicideandrisk.aspx 　　

http://www.guardian.co.uk/society/2010/jul/07/patchy-nhs-services-lives-risk-self-harm

Definition of Self-Harm (Samaritans document)