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Tackling the rise in self-harm: ‘Many professionals feel ill-equipped’

The rise in self harm among young people has partly been blamed on social media.
The rise in self-harm among young people has partly been blamed on social media. Photograph: Mixmike/Getty Images

The scale of self-harm among young people is beyond worrying: a study published recently found that almost one in four girls aged 14 self-harmed in the past year. In the same month, the NHS reported that the number of girls aged under 18 admitted to hospital in England after self-harming had nearly doubled in the past 20 years.

Dig into what’s driving this crisis and experts working in children’s mental health will flag up a range of factors. “Part of the blame is down to higher demands from society,” argues Dr Maite Ferrin, a locum consultant psychiatrist at Haringey Child and Adolescent Mental Health Service. “Young people are being asked to be successful and good-looking and show that life is perfect [on social media].” Another alarming reason is peer pressure. “There’s a tendency for some [young] people to self-harm as a way to fit into a group because the rest of the peer are self-harming,” says Ferrin, who also works at Re:Cognition Health.

Mark Monaghan, senior practitioner in children’s services and British Association of Social Workers (BASW) social worker, says he’s noticed a rise in self-harming. “There’s more scratching behaviour and cutting. One thing that’s driving it is that young people are frustrated and worn down.”

So how prepared are social workers in helping combat self-harm among young people? Rather inadequately, according to BASW.

“There’s no specific mandatory training [on self-harm],” says Wayne Reid, professional officer at BASW and a qualified registered social worker. “Different courses exist – there are courses that touch on self-harm but these are around mental health or supporting challenging behaviours.” He says lack of funding and high caseloads means this sort of training is not seen as a priority. “Social workers on the ground would love time to do direct work to resolve issues like self-harm.”

Monaghan echoes Reid. “Training can be hit or miss. It’s quite a grey area for some social workers.”

The vast majority of young people involved in self-harming behaviours will not be presenting to hospitals

Rick Bradley

However there are ad hoc projects springing up across the country aimed at boosting awareness among professionals. One such initiative is Self-Harm Awareness and Resource Project (Sharp). Set up by Nottingham city clinical commissioning group (CCG), it offers support and training to frontline professionals and service providers as well as offering one-on-one support to children through dedicated clinics in secondary schools and colleges.

“We came up with Sharp five years ago, as there had been a massive increase in self-harm,” says Sharp manager Sharon O’Love. “What was happening in schools and in the community was that people were going into panic response if someone had self-harmed and they’d be taken to hospital. We needed a preventative model rather than dealing with people when in hospital.” So far, Sharp has trained more than 6,000 professionals, says O’Love. The training covers issues such as understanding warning signs and how to support families.

Charities are also ensuring that frontline staff, including social workers, are armed with a high level of knowledge and understanding when it comes to self-harm. Naomi Salisbury, director of Self Injury Support, which runs workshops for people working in health, social care and education, says: “We find that people within social care often feel less confident about their skills, but when we speak to them they are very human [in the way they interact] with their clients and that’s what we recommend in our training.”

In Kent and Cornwall, mental health, drug and alcohol charity Addaction runs a programme providing early intervention support for young people aged 13-17. The programme, Mind and Body, visits schools and pupils who are already self-harming or vulnerable to it are invited to a block of eight group sessions.

The service in Kent has also trained or given advice to more than 400 professionals in the past financial year about how best to support young people. Rick Bradley, Mind and Body operations manager, says: “We would definitely look to roll this out further afield as there is a real need; despite best intentions, many professionals feel very ill-equipped in terms of asking young people about self-harm for fear of making things worse.”

However, with the government’s austerity programme impacting funding and provision, is enough being done to tackle the problem?

Jessica Hunter, a volunteer for Self Injury Support and a former self-harmer, believes there needs to be more investment. “I know services do their best but [they are] also horrendously overstretched and underfunded,” she says. “There’s absolutely not enough people and not the capacity to offer support to everyone who needs it.”

Bradley believes self-harming figures are likely to be the tip of the iceberg. “The vast majority of young people involved in self-harming behaviours will not be presenting to hospitals – most will be off the radar of mental health services, and often even school pastoral teams, family and friends,” he says. “We must help those in crisis but also look upstream, helping individuals build positive coping strategies to divert them from specialist services in the future.” Without this, he says, the situation is only likely to get worse.

  • In the UK, Samaritans can be contacted on 116 123 or email jo@samaritans.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.