Self-harm is an increasingly recognised phenomenon and one of the strongest predictors of suicide, which continues to be one of the leading causes of death in young people worldwide. Self-harm can take many forms and may present with or without suicidal intent and both in the context of mental disorder, and without. Worldwide, 10-20% of young people report having self-harmed at least once before the age of 18 and self-harm is one of the strongest risk factors for completed suicide (3). Suicide is the 2nd leading cause of death for young people globally and therefore predictors such as self-harm are of great importance. The World Health Organization reported that from the Global School-Based Health Survey the 12-month prevalence of suicidal ideation in females was 16.2% and for males 12.2%. Suicidal ideation with plans was reported in 8.3% and 5.8% respectively, but with significant heterogeneity amongst countries. Lifetime figures for suicidal ideation are as high as 29.9%, with 9.7% having attempted suicide. Self-harm and suicide are related phenomena which in different countries are defined in slightly different ways. The International Classification of Diseases defines intentional self-harm as: purposely self-inflicted poisoning or injury, including attempted suicide, and this definition is most commonly adopted within Europe including the UK and in Australia. The fifth edition of the Diagnostic Statistical Manual of Diseases now includes Non-suicidal self-injury disorder. Non-suicidal self-injury (NSSI) is described as “deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned”; this is reflected in the research output from the United States and Canada. This definition does not include self-poisoning. Within this classification, self-harm with any level of suicidal intent is defined as a suicide attempt. Self-harm with and without suicidal intent are both important risk factors for suicide, and intent can be difficult, even for young people themselves, to determine. It is therefore important that all acts of self-harm are thoroughly explored and addressed with young people.
See our written Self-harm and Suicide Topic Guide
Suicide
