Finding ways to support and identify children and young people (CYP) who self-harm is an important social issue. Incidences of self-harm in CYP in the UK have risen in the last 20 years, with the UK having one of the highest rates in Europe. Self-harm is a complex issue and has been identified as a risk factor for suicidal ideation and suicide (McManus et al., 2019). Early intervention and preventative strategies need to be in place to reduce the incidents of CYP self-harming and to save lives.
There is a plethora of research about self-harm in adolescents. However, very little is known about self-harm during the primary school years despite retrospective studies reporting participants recalling the onset of their self-harm during their primary school years (Spandler, 1996). Primary school leaders have also reported increasing numbers of children self-harming (The Key, 2017). Early intervention and support should therefore be provided.
Schools have been positioned at the ‘heart’ of transforming CYP’s mental health (DHSC & DfE, 2017) placing them in a pivotal role in tackling the rising trend in incidents of self-harm and death by suicide. Weare (2015) advocates that for mental health transformation to take place, a ‘whole-school approach’ is required whereby children, parents and staff have a shared language and approach.
One of the challenges in having a common language for self-harm is that it has been identified as a complex and contentious issue which is not well understood (Townsend, 2016). From a medical perspective self-harm is defined as ‘any act of self-poisoning or self-injury carried out by an individual irrespective of motivation’ (NICE, 2013, p. 6). However, this negates self-induced psychological harms. For example, self-deprecating thoughts.
‘One of the challenges in having a common language for self-harm is that it has been identified as a complex and contentious issue which is not well understood.’
Drawing upon the adolescent research, self-harm has been identified as a coping strategy to aid emotional regulation. Adolescents have reported hurting themselves when feeling low, anxious, lonely, stressed, self-hatred and anger (Laye-Gindhu & Schonet-Reichl, 2005). This suggests when a young person experiences intense emotions and thoughts they may opt for a coping strategy that is harmful to themselves as a release to be able to emotionally regulate.
From the stance that self-harm is a coping mechanism to aid emotional regulation and schools are best understood as a whole, my current research has begun to explore self-harm in primary-aged schoolchildren by capturing the voices of children, parents and school staff. Initial findings confirm that children in the primary school age range are hurting themselves physically and with self-deprecating thoughts. Children feel teachers can support them by listening to them and helping them to manage intense feelings. Parents and school staff also felt schools have a role in supporting children who self-harm, but they also needed the support of specialist services who are experts in this field.
Self-harm in the primary school age range may be considered a difficult topic to discuss and research. However, we cannot ignore schools reporting increases of incidences of children self-harming. We need to act now to prevent self-harm in primary-aged schoolchildren becoming the norm while also providing support for those that are physically and mentally hurting themselves.
Department of Health [DHSC], & Department for Education [DfE]. (2017). Transforming children and young people’s mental health provision: A green paper. London. Retrieved from https://www.gov.uk/government/consultations/transforming-children-and-young-peoples-mental-health-provision-a-green-paper
Guerreiro, D. F., Cruz, C., Frasquilho, D., Santos, J. C., Figueira, M. L., & Sampaio, D. (2013). Association between deliberate self-harm and coping in adolescents: A critical review of the last 10 years of literature. Analysis of Suicide Research, 17, 91–105.
Laye-Gindhu, A., & Schonert-Reichl, K. A. (2005). Nonsuicidal self-harm among community adolescents: Understanding the ‘whats’ and ‘whys’ of self-harm. Journal Youth Adolescence, 34(5), 447–457.
McManus, S., Gunnell, D., Cooper, C., Bebbington, P. E., Howard, L. M., Brugha, T., Jenkins, R., Hassiotis, A., Weich, S., & Appleby, L. (2019). Prevalence of non-suicidal self-harm and service contact in England, 2000–14: Repeated cross-sectional surveys of the general population. Lancet Psychiatry, 6(7), 573–581. https://doi.org/10.1016/S2215-0366(19)30188-9
National Institute for Health and Care Excellence [NICE]. (2013). Self-harm quality standard: NICE quality standard [QS34]. London. Retrieved from https://www.nice.org.uk/guidance/QS34/chapter/Introduction-and-overview
Spandler, H. (1996). Who’s hurting who? Young people, self harm and suicide. Manchester: 42nd Street.
The Key. (2017). State of education survey report 2017. Rising to the challenge: Examining the pressures of schools and how they are responding. London.
Townsend, E., Wadman, R., Sayal, K., Armstrong, M., Harroe, C., Majumder, P., Vostanis P., & Clarke. D. (2016). Uncovering key patterns in self-harm in adolescents: Sequence analysis using the card sort task for self-harm (CaTs), Journal of Affective Disorder, 206, 161–168.
Weare, K. (2015). What works in promoting social and emotional well-being and responding to mental health problems in schools? National Children’s Bureau: London. Retrieved from https://www.mentalhealth.org.nz/assets/ResourceFinder/What-works-in-promoting-social-and-emotional-wellbeing-in-schools-2015.pdf