From the Guidelines
Self-harm is most prevalent among young females, with the highest rates observed in those aged 16 years. This is based on recent evidence from a 2025 study published in the Journal of Child Psychology and Psychiatry and Allied Disciplines 1. The study highlights that self-harm typically begins in early adolescence, aged 10–14 years, peaking in frequency around age 16 years. Key factors associated with self-harm include:
- Mental health conditions such as depression and anxiety
- History of childhood trauma, abuse, or neglect
- Eating disorders and borderline personality disorder
- Being part of the LGBTQ+ community, which experiences higher rates compared to heterosexual peers
- Being in institutional settings like psychiatric facilities or colleges
The prevalence of self-harm is significant, with non-fatal self-harm in young people being very common, frequently repeated, and associated with an increased risk of suicide 1. For every young female aged 12–17 years who dies by suicide, there are around 1,000 episodes of hospital-presenting self-harm. Early intervention is crucial and may include psychotherapy, addressing underlying mental health conditions, developing healthy coping mechanisms, and in some cases, medication to treat co-occurring psychiatric disorders. Creating a safety plan and removing access to means of self-harm are important immediate interventions.
Given the complexity and the high risk of suicide associated with self-harm, particularly in young females around the age of 16, it is essential to prioritize early and comprehensive intervention strategies. These should be tailored to the individual's specific needs and circumstances, taking into account their mental health status, history of trauma, and other risk factors. By doing so, we can work towards reducing the morbidity, mortality, and improving the quality of life for those affected by self-harm.
From the Research
Prevalence of Self-Harm
- The prevalence of self-harm is a significant concern, particularly among adolescents and young adults 2.
- A study found that 12.1% of adolescents reported a lifetime history of self-harm, with factors such as exposure to self-harm of a friend or family member being independently associated with self-harm 2.
- Another study found that self-harm is common in adolescents, but seeking professional help is not a common phenomenon, with only 6.9% of adolescents presenting to hospital as a result of their last self-harm act 2.
Methods of Self-Harm and Risk of Suicide
- Certain methods of self-harm, such as violent methods, may indicate a higher risk of suicide, particularly among adolescents and young adult women 3.
- A study found that among adolescents with initial medical hospitalization, use of a violent method was associated with a near eightfold increase in the risk of suicide compared to self-poisoning 3.
- Among hospitalized young adult women, the risk of suicide was elevated fourfold for both cutting and violent methods 3.
Treatment of Self-Harm
- Dialectical behavior therapy (DBT) has been shown to be effective in reducing self-harming behaviors and alleviating depression in patients with borderline personality disorder 4, 5.
- A meta-analysis found that DBT reduced self-harming behaviors and improved depression, but had a negligible effect on suicidal ideation and anger 5.
- The addition of fluoxetine to DBT did not provide any additional benefits in the treatment of borderline personality disorder 6.