So many young people are self-harming that it risks becoming normalised and increasing the number who commit suicide when they are older, a study reveals.
One in five girls and young women in England aged 16 to 24 have cut, burned or poisoned themselves, according to research that mental health experts said was “very worrying”.
The findings, published in the Lancet Psychiatry journal, show that self-harm has risen across both sexes and all age groups since 2000. In the population as a whole it almost trebled from 2.4% then to 6.4% in 2014.
The number of people overall cutting themselves jumped from 1.5% to 3.9% over those 14 years.
Growing numbers of people are harming themselves as a way of coping with feelings of anger, tension, anxiety or depression. However, a lack of NHS services and people’s unwillingness to seek help means that more than half of those who self-harm do not receive any medical or psychological care.
“An increase in the prevalence of using self-harm to cope with emotional stress could have serious long-term implications,” said Prof Louis Appleby of Manchester University, one of the authors.
“There is a risk that self-harm will become normalised for young people, and individuals who start to self-harm when young might adopt the behaviour as a long-term coping strategy.
“Non-suicidal self-harm may be associated with later suicide. As young people get older, reaching age groups that already have higher suicide rates, the self-harm they have learned may become more serious and more likely to have a fatal outcome,” he added.
But self-harm has risen the fastest, and is now the most common, among females aged 16 to 24. The proportion of that age group who have self-harmed increased from 6.5% in 2000 to 19.7% in 2014.
Self-harm has also risen over the same 14-year period among males in the same 16-24 bracket, but less dramatically, from 4.2% to 7.9%.
The study, funded by the NHS and the government, is based on analysis of data collected for the Adult Psychiatric Morbidity Survey, which comes out every seven years. It involved three cohorts of between 6,444 and 7,243 people aged 16 to 74.
The number of people of all ages self-harming to help them cope with unpleasant feelings trebled from 1.8% to 5.4% between 2000 and 2014. But this motivation was again commonest in 2014 among 16- to 24-year-olds – acting as a prompt among 17.7% of females and 5.8% of males that age.
Similarly, women overall are more likely than men to use self-harm to try to change their situation (3.6%), with 7.3% of females aged 16-24 in 2014 citing that as a reason.
Jemima Olchawski, the chief executive of Agenda, the alliance for women and girls at risk, said physical and sexual abuse were key reasons why so many more women than men were self-harming.
“It’s very worrying to see this sharp increase in self-harm, particularly among young women. It’s clear young and girls are facing a mental health crisis,” she said.
“We can’t ignore the fact that poor mental health among women and girls is often closely linked to violence and abuse, such as experience of physical abuse from a partner, sexual abuse as a child or sexual abuse as an adult.”
Research has found that more than half of women with a mental health problem have suffered abuse, with 25% experiencing that as a child.
Emma Thomas, the chief executive of YoungMinds, said childhood poverty, neglect and abuse, exam pressures, bullying using social media and increasing concerns over body image were driving up rates of self-harm.
However, despite the “steep increases” in self-harm detected, the proportion of participants who then got support from medical or psychological services is declining. Almost 60% of those in the 2014 survey received no such help, an increase on the 2000 and 2007 samples.
Experts warned that people self-harming because they are in mental turmoil are being denied help because NHS care is still inadequate. Thomas said: “At the moment, it’s far too difficult for children and young people to get mental health support before they reach crisis point.”
NHS England has pledged to greatly increase the availability of mental health care, especially for young people and those of any age undergoing a mental health crisis. Services are more plentiful than 2014, the last year on which the new findings are based, sources pointed out.
‘Cutting myself was an outlet for the pain I was feeling’
Nikita, who is 27, self-harmed for two years from the age of 13. She is now the deputy chair of trustees at the Wish Centre self-harm project in Harrow, north London, where peer support helped her to stop cutting herself.
“I would cut my arms and legs. I still have the scars from doing that.
“Why did I do it? At the time, I had a lot of friendship issues. There were difficulties with relationships and rivalries and I didn’t feel that I really fitted in anywhere. I was still figuring out who I was, where I wanted to go in life and was feeling low on self-confidence and a bit worthless, and that I would never achieve anything.
“I felt like a failure, like I was always letting people down around me. I ended up in self-destruct mode, and doing harm to myself emotionally, like being in a friendship group that wasn’t healthy or good for me.
“It got to the stage where I was self-harming every day, was on the verge of being expelled from school and didn’t feel like I had anyone in my life who wanted me around and who I could confide in. I feared that I was going to feel like this for the rest of my life and that I would remain meaningless.
“When I cut myself I felt a sense of relief. It was an outlet for the pain I was feeling. I felt like I was punishing myself. I wanted to inflict pain on myself, because I felt I should have been a better person, better friend and better daughter than I was. After cutting myself I felt that I had punished myself and could go about the rest of my day. This went on until I was 15.
“My school referred me to the Wish Centre, where I got a combination of counselling and peer support, and I was able to stop self-harming. That felt like a big victory, because until then I felt like cutting myself was something I would always do.
“I’m proof that people can recover from self-harming. I’ve never relapsed since I stopped 12 years ago.
“There is a lot of self-harm around. That’s due to childhood abuse, family relationship problems, mental health issues, low self-esteem and bullying. But I don’t think it’s more common these days. I just think people are more open about it than before.”
As told to Denis Campbell
• In the UK and Ireland, Samaritans can be contacted on 116 123 or email email@example.com or firstname.lastname@example.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.