New research investigates the risk of repeat self-harm and suicide for young people

A study published by researchers at the Black Dog Institute and the University of New South Wales (UNSW) Medicine and Health investigated the risk of repeat self-harm and suicide in young people.

The study found that adolescents and young adults were at high risk of repeat self-harm and suicide death following an initial or ‘index’ presentation to hospital for self-harm. The risk was highest in the first year following the index presentation, particularly the first month.

The research analysed data of over 81,000 hospital presentations for self-harm, among 48,547 individuals aged 10-29 years during 2014 to 2019 in New South Wales. Around one quarter engaged in self-harm more than once. The risk of repeat episodes of self-harm was highest among children and adolescents between 10 and 19 years and for more severe presentations requiring hospital admission.

Self-harm presentations were much more prevalent in females, however repeat self-harm and suicide death was higher for males.

Self-harm is a risk factor for suicide. Whilst suicidal intent was unable to be determined from the data, reducing the extent of self-harm for young people can help to prevent future self-harm episodes and potentially suicides. With children as young at 10 years old repeat self-harming, interventions to support children and young people are a priority.

Senior study author, Dr Michelle Tye, said in a media release that “Self-harm is fundamentally a maladaptive coping behaviour, so we need to find ways to stop young people from getting to the point of engaging in suicidal behaviour and shift them to adaptive coping behaviours.”

The researchers suggest that more evidence-based programs in schools would help expose large cohorts of young people to adaptive coping strategies, raise awareness of the warning signs of suicide and non-suicidal self-harm and educate young people about how to seek help.

The experience of presenting to the emergency department for self-harm can be varied, and there is a need to improve clinical assessment in frontline health services. Coordinated aftercare following presentation to hospital is also important, with repeat presentations highest in the following month.

This study only examined self-harm presentations resulting in presentation to hospital and the true extent of self-harm in the community is likely much more widespread. However, those who come in contact with the hospital system provide a cohort who can provide insights and guide new directions and opportunities for interventions.