Child and adolescent mental health

Self harm

  • The rate of self-harm is relatively low in early childhood, but increases rapidly with the onset of adolescence
  • Most acts of self-harm in young people never come to the attention of care services and it is also likely that many parents are unaware of the problem (1)
  • It is thought that girls are three times more likely to self harm than boys
  • Emergency hospital admissions for self-harm in children and young people 10 to 19 years old have risen nationally in the last three years. The local rate has significantly increased for girls over the same period (2)

Prevalence of self-harm

The Central Bedfordshire population aged 10 to 19 years was 30,400 in 2013, and applying the national prevalence of 1 in 15 to this figure indicates that there are likely to be around 2,030 children and young people self-harming in the last year (3)

  2011/12 2012/13 2013/14
Emergency hospital admissions for self-harm in Central Bedfordshire, children and young people 10 to 19 years old, 2011/12 to 2013/14
Males 11 20 13
Females 39 60 102
Age 10-14 11 11 30
Age 15-19 39 69 85

Source: Medeananalytics

Emergency hospital admissions

A small proportion of self-harming behaviour has life-threatening consequences resulting in emergency hospital admission and sometimes death. In 2013/14 there were 115 A&E admissions for self-harm (Figure 7). In previous years, admissions for self-harm were three to four times more common in girls than boys, consistent with national findings. In 2013/14 however the gap appeared widen and admissions for self-harm were nearly eight times more common in girls than boys. The number of admissions in girls more than doubled in three years from 39 to 102 admissions. Expressed as a proportion of the underlying population this represents a statistically significant increase from 27 to 69 per 10,000 (Figure 8). In 2011/12 the rate of emergency hospital admissions for self-harm in girls in girls was significantly lower than the England and NHS Area Team averages. In 2012/13 and 2013/14 admissions in Central Bedfordshire increased at a faster rate than the national average and is now similar to England overall.

The rate of emergency hospital admission for self-harm in boys has not significantly increased over the last three years, and in 2013/14 the rate was significantly lower than the England average.

The apparent rise in girls could reflect a true increase in the underlying rate of life threatening self-harm behaviour, or it could reflect either changes in hospital coding practice or admission thresholds. However, it is unclear why changes in coding or admission practice would disproportionately affect girls. The increase was observed across multiple hospital trusts, which also makes it less likely that changes in coding or admission practice are responsible.

Emergency hospital admissions for  self-harm in Central Bedfordshire, females aged 10 to 19 years old, 2011/12 to 2013/14

Emergency hospital admissions for self-harm in Central Bedfordshire, females aged 10 to 19 years old, 2011/12 to 2013/14

Rate per 10,000. Error bars are 95% confidence intervals. Source: Medeanalytics, ONS and NHS England.

Deprivation

The rate of admission is highest in the most deprived category and lowest in the least deprived category (Figure 9).

Emergency hospital admissions for self-harm in Central Bedfordshire, children and young people 10 to 19 years old, by deprivation quintile.

Emergency hospital admissions for self-harm in Central Bedfordshire, children and young people 10 to 19 years old, by deprivation quintile.

Rate per 10,000. Error bars are 95% confidence intervals. Source: Medeanalytics and ONS.

The Central Bedfordshire Health related behaviour and perception survey 2014 survey

Central Bedfordshire Council commissioned the Schools Health Education Unit (SHEU) to run a survey in 2014 on children and young people’s perceptions of their health and lifestyles.  A sample of 3099 pupils from years 6, 8 and 10 years took part in the survey and results were compared to the CBC 2008 survey data as well as with wider SHEU data. These data helped to inform and drive projects in 2014/15 aimed at raising pupil’s health in Central Bedfordshire.

The results of the CBC survey were discussed at an open event for PSHE leads and teachers who were given the opportunity to meet the children’s Public Health team, consider individual school data and discuss the implications for pupils. The summary data were also shared with key partners to inform their own policy decisions and priorities. For example the survey was shared with the Bedfordshire Police Strategic Children and Young People Group and gave senior officers an opportunity to look at the results and determine if the forces education work was covering the needs of young people in Central Bedfordshire, The force’s Children and Young People Development Officer and Schools Coordinator was tasked to promote the range of educational inputs on offer to schools to support them with a range of topics such as personal safety, online safety and bullying.

Comparisons of Central Bedfordshire Year 6, Year 8 and Year 10 results with wider SHEU data showed that Central Bedfordshire pupils are more likely to:

  • Worry about more than one matter listed in the survey
  • Have low self esteem scores 
  • Feel their views are not listened to in school
  • Sometimes feel afraid of going to school due to bullying
  • Feel less satisfied with their lives

When compared to the Central Bedfordshire 2008 survey results, pupils in 2014 are less likely to report they are satisfied with their lives. This downward trend is also seen in wider SHEU data, which reflect the national trend.

References

(1) Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care National Clinical Practice Guideline Number 16. National Collaborating Centre for Mental Health commissioned by the National Institute for Clinical Excellence

(2) Self-Harm among Children and Young People in Central Bedfordshire February 2015 Population Health, Evidence and Intelligence Team. Bedford Borough and Central Bedfordshire Council

(3) Joint Commissioning Panel for Mental Health, Guidance for commissioning public mental health services

 


Last updated Friday, 22nd April 2016