Abstract
Background
Deliberate self-harm (DSH) is a major problem in young people in the United Kingdom. The majority of young people who harm themselves do not seek help and therefore community based prevention strategies are important. However little is known about young peoples’ views on the prevention of DSH. The aims of this study were to identify what adolescents believe can be done to prevent them from feeling like they want to harm themselves, and to investigate differences in the views held according to gender, ethnic group and previous experiences of self-harm.
Method
Pupils in a representative sample of 41 secondary schools in England completed an anonymous, self-report questionnaire including the question “what do you think could be done to help prevent young people from feeling that they want to harm themselves?” Thematic analytic methods were used to categorise responses, which were then also analysed by gender, ethnicity, lifetime history of DSH and lifetime exposure to DSH among friends.
Results
The written responses of 2,954 students aged 15–16 years were analysed. Eleven broad categories of responses were identified covering causes and possible ways of preventing suicidal behaviour in young people, including; the primacy of informal social networks over professional organisations, the importance of confiding stable relationships, the need for structured group activities, and the key role that schools play in young peoples lives. Mental illness was mentioned by only 3% of respondents, although concerns about stigma acted as a barrier to seeking help for some young people. Bullying and serious problems at home were highlighted as psychosocial stressors that need to be addressed.
Conclusions
The adolescents in this study considered family, friends and school as the main sources of support in preventing suicidal behaviour, and more pertinent than external helping agencies. Enhancing the provision of school-based mental heath programmes and increased youth-orientation in helping services are indicated.
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References
de Anda D, Smith MA (1993) Differences among adolescent, young adult, and adult callers of suicide help lines. Soc Work 38:421–428
Aseltine RH, DeMartino R (2004) An outcome evaluation of the SOS Suicide Prevention Program. Am J Public Health 94:446–451
Burgess S, Hawton K, Loveday G (1998) Adolescents who take overdoses: outcome in terms of changes in psychopathology and the adolescents’ attitudes to care and to their overdose. J Adolesc 21:209–219
Coggan C, Bennett S, Hooper R, Dickinson P (2003) Association between bullying and mental health status in New Zealand adolescents. Int J Mental Health Promo 5:16–22
Coggan C, Patterson P, Fill J (1997) Suicide: qualitative data from focus group interviews with youth. Soc Sci Med 45:1563–1570
Deane FP, Todd DM (1996) Attitudes and intentions to seek professional psychological help for personal problems or suicidal thinking. J Coll Student Psychotherapy 10:45–59
Department of Health (2002) National suicide prevention strategy for England. Department of Health, London
Department of Health (2004) National service framework for children, young people and maternity services. Department of Health, London
Dunham K (2004) Young adults’ support strategies when peers disclose suicidal intent. Suicide Life Threat Behav 34:56–65
Evans E, Hawton K, Rodham K (2004) Factors associated with suicidal phenomena in adolescents: a systematic review of population-based studies. Clin Psychol Rev 24:957–979
Goldacre M, Hawton K (1985) Repetition of self-poisoning and subsequent death in adolescents who take overdoses. Br J Psychiatry 146:395–398
Gould MS, Munfakh JLH, Lubell K, Kleinman M, Parker S (2002) Seeking help from the Internet during adolescence. J Am Acad Child Adolesc Psychiatry 41:1182–1189
Gould MS, Velting D, Kleinman M, Lucas C, Thomas JG, Chung M (2004) Teenagers’ attitudes about coping strategies and help-seeking behavior for suicidality. J Am Acad Child Adolesc Psychiatry 43:1124–1133
Green J (1998) Grounded theory and the constant comparative method: commentary. Br Med J 316:1064–1065
Hawton K, et al. (2003) Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990–2000. J Child Psychol Psychiatry 44:1191–1198
Hawton K, et al. (2007) Self-harm in England: a tale of three cities. Soc Psychiatry Psychiatr Epidemiol 42:513–521
Hawton K, Rodham K, Evans E, Weatherall R (2002) Deliberate self harm in adolescents: self report survey in schools in England. Br Med J 325:1207–1211
Heled E, Read J (2005) Young peoples’ opinions about the causes of, and solutions to, New Zealand’s high youth suicide rate. Suicide Life Threat Behav 35:170–180
Meltzer H, Harrington R, Goodman R, Jenkins R (2001) Children who try to harm, hurt or kill themselves. Office for National Statistics, London
Merry S, McDowell H, Wild CJ, Bir J, Cunliffe R (2004) A randomized placebo-controlled trial of a school-based depression prevention program. J Am Acad Child Adolesc Psychiatry 43:538–547
Ministry of Health (1998) New Zealand youth suicide prevention strategy: in our hands/kia piki te ora o te taitamariki. Ministry of Health, Wellington
Nada-Raja S, Morrison D, Skegg K (2003) A population-based study of help-seeking for self-harm in young adults. Aust N Z J Psychiatry 37:600–605
Nicholas J, Oliver K, Lee K, O’Brien M (2004) Help-seeking behaviour and the Internet: an investigation among Australian adolescents. Aus E J Adv Mental Health 2004 Available from:http://www.auseinet.com/journal/vol3iss1/nicholas.pdf. Accessed on 6 December 2004
Pirkis J, Blood RW (2001) Suicide and the media: a critical review. Commonwealth Department of Health and Aged Care, Canberra
QSR Nvivo (2002) QSR International Pty Ltd. Doncaster, Victoria, Australia
Salmon G, James A, Smith DM (1998) Bullying in schools: self reported anxiety, depression, and self esteem in secondary school children. BMJ 317:924–925
Scottish Executive (2002) Choose life: a national strategy and action plan to prevent suicide in Scotland. Edinburgh
Sinclair J, Green J (2005) Understanding the resolution of deliberate self-harm: a qualitative interview study of patients’ experiences. Br Med J 330:1112–1115
Storey P, Hurry J, Jowitt S, Owens D, House A (2005) Supporting young people who repeatedly self-harm. J R Soc Promo Health 125:71–75
Wilson CJ, Deane FP (2001) Adolescent opinions about reducing help-seeking barriers and increasing appropriate help engagement. J Educ Psychol Consult 12:345–364
Acknowledgements
Funding for this project was provided by the Camelot Foundation and the Mental Health Foundation under the auspice of the National Inquiry into Self-Harm Among Young People. Julia Sinclair was supported by the Medical Research Council and Keith Hawton by Oxfordshire and Buckinghamshire Mental Health Partnership NHS Trust. We also acknowledge the financial support of the Community Fund, Samaritans and the pupils and teachers of schools that participated in this study. We thank Karen Rodham and Emma Evans who were responsible for data collection for the study from which the material for this project was derived and Ann Lewins, University of Surrey, for her assistance with NVivo.
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Fortune, S., Sinclair, J. & Hawton, K. Adolescents’ views on preventing self-harm. Soc Psychiat Epidemiol 43, 96–104 (2008). https://doi.org/10.1007/s00127-007-0273-1
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DOI: https://doi.org/10.1007/s00127-007-0273-1