In the UK (as well as giobally), we are in the midst of a mental health crisis. Children under 18, particularly teenage girls are struggling with episodes of mental illness. What has become apparent is that rates of self harm, where someone intentionally harms themselves to relieve mental suffering, have rocketed.
In August 2018, the BBC reported on the Good Childhood report by the Children’s Society which was released, after collecting data in the Millennium Cohort study. The study looked at 19,000 children born between 2000 and 2001.
The Good Childhood report stated that more than a fifth of 14 year olds in the UK said they had self harmed in 2017.
According to the BBC, ‘ A survey of 11,000 children found that 22% of girls and 9% of boys said they have hurt themselves on purpose in the year prior’. The report also found that rates of self harm were worse for those who were attracted to the same gender (due to the complexities this may bring up for the child). Other issues such as gender stereotypes, self image and social media appear to be worsening children and teens mental health.
Additionally in summer 2018, the NHS" released important data which also concurred with the Childrens Society Report. The data showed that the number of hospital admissions of girls aged 18 and under for self harm had doubled in two decades, from 7,327 in 1997 to 13,463 in 2017.
This is shocking and as adults, we must learn how to navigate this new mental health landscape and help any children in our care.
So what is self harm ?
The NSPCC on their website page ‘Preventing Abuse and keeping children safe’ notes that
‘ Self harm can take lots of physical forms, including cutting, burning, bruising, scratching, hair pulling, poisoning and overdosing. There are many reasons why children and young people hurt themselves, and once they start it can become a compulsion (that is hard to give up)’
Self harm is often a way to release intense and overwhelming emotions that they cannot cope with. The mental health charity Mind" defines self harm as ‘hurting yourself as a way of dealing with very difficult feelings, painful memories or overwhelming situations and experiences’
Instead of turning outwards for support, the child may hurt themselves to relieve their distress, in order to cope.
There are various warning signs of self harm behaviours. These are both physical and emotional. According to the NSPCC, the physical include ‘cuts, bruises, burns and bald patches from hair pulling on head, wrists, arms and thighs’. Mind charity adds poisoning, biting, picking and scratching at skin, hitting oneself and excessive exercise to this list.
NSPCC" say that the emotional aspects of self harm are harder to spot but if coupled with the physical signs, it is likely the child is self harming.
Emotional signs of self harm can include depression, low self esteem and tearfulness, becoming withdrawn, unusual eating habits and abusing alcohol or drugs. They note that when a child self harms they may be punishing themselves.
Self harm behaviour can be addictive too- due to the endorphins released into the brain to calm the body when it occurs. There will be a cycle too and instant relief followed by guilt and shame. Some may try to hide their scars under long, baggy clothing and others may neglect their wounds so it is important to watch out for this. Its also vital to notice whether someone you suspect of self harming is at risk of suicide or expressing suicidal ideation.
In Nadeem Badshahs article in the Guardian, he writes that an NSPCC spokesperson said, ‘We know from contacts to Childline that many children are being driven to self-harm as a way of dealing with the pressures and demands of modern-day life. Young people are crying out for help.”
In response to the findings of the 2018 study, a Department of Health and Social Care spokesman said, “Making sure children and young people have the right mental health care when they need it is vital. That’s why we are investing an extra £300m to provide more help in schools, which will include trained staff to provide faster support to children. ..we’ve extended our pilot scheme to deliver training in 20 more areas of the country this year to improve links between 1,200 schools and their mental health services.”
It is hoped that the NHS and CAMHS will be able to deal with the upsurge in self harm and depression incidents, however this remains to be seen. With psychiatry budgets stretched to breaking point it is unclear if this funding will make a large difference. At the time of writing, Theresa May has just announced more long term funding for mental health services in her 10 year plan for the NHS, which will hopefully help more people.
Why are teenage girls self harming in particular?
There are many reasons for this. Teenagers today have particular sets of challenges , that previous generations didn’t face. They are bombarded with perfect, filtered and photoshopped Instagram and social media images. They can compare their lives to each others on these apps and may feel lonely and not good enough. Additionally, the rise of online bullying and trolling also means that they are no longer safe from being bullied at home.
Add to this that adolescence is traditionally a time for self development (and self esteem changes) , finding oneself, heightened emotions, testing boundaries (as well as all those hormones) and you have a recipe for disaster.
Here in the UK, many teenage girls have reported feeling lonely and this is affecting their mental health. They often internalise distress and need an outlet for it, which they may find in self harm. Teen girls have a special set of circumstances to contend with, that of being a young woman in a rapidly changing world.
Natalie Gil writes in her Refinery29 article that ,
‘Traditional gender stereotypes and worries about looks are among the biggest factors contributing to the trend, The Children's Society said. Children whose friendship groups value "girls having nice clothes and boys being tough" reported lower wellbeing.’
Furthermore, Matthew Reed, chief executive at The Children's Society is quoted as discussing why teenage girls are self harming more, ‘Worries about how they look are a big issue, especially for girls, but this report shows other factors such as how they feel about their sexuality and gender stereotypes may be linked to their unhappiness’
Worries about their sexuality and whether they will be accepted is a big issue for many young girls. Also, appearance and weight can be a big trigger to self harm, as well as feeling lonely, unloved and less able to cope with school or home life. As young women they may feel the need to be and look ‘perfect’, something fuelled by society around them.
What can one do to help?
It is really important that schools, parents, guardians, CAMHS mental health services, GPs and anyone involved in the care of a young person, looks out for signs that they may be in distress with their mental health and are self harming. As discussed above, there are important physical and emotional signs to look out for.
At school, the young person should have a trusted teacher or school counsellor that they can confide in. Schools have safeguarding policies to protect those in their care, so it may be that you encourage your child to visit the counsellor or if they feel in danger of hurting themselves during the day- to go to a designated staff member as agreed prior. This could be the teacher in charge of child protection, to set up a face to face meeting to discuss your child.
Another port of call would be visiting the childs GP with them, if they are willing. If they trust their doctor, the doctor can speak to them non judgementally about what is going on and offer advice. If they feel its vital and needed, they may refer the child to a CAMHS (Child and Adolescent mental health service) psychologist or psychiatrist if your child is depressed and needs medication. You can also access counselling through the GP, though this has long waiting lists and of course there is always private counselling.
As well as this, there are the Samaritans. NSPCC and Childline helplines which your child can speak to if they feel comfortable and need a listening ear from a non family member.
The most important thing is not to get angry, to be non judgemental and to help the young person through this period in their life as best they can. Speak to medical professionals (doctors have seen this before and can offer degrees of support) and seek help from the school and teachers to support your child.