Children self-harm aged nine, warn nurses

Children as young as nine are deliberately self-harming and attempting suicide, nurses have warned.

Rising rates of young people are cutting their bodies, turning to drink or drugs or even trying to hang themselves, the annual conference of the Royal College of Nursing (RCN) was told.

Despite the problem, funds for child and adolescent mental health services are being cut and there is a severe shortage of in- patient psychiatric beds for youngsters.

An estimated one in 15 young people is thought to self-harm, according to a recent report.

Jacqui Nelson, a child and adolescent mental health nurse from Northern Ireland, said: "I have had a nine-year-old who wanted to kill himself and had tried hanging himself.

"I have seen children of 11 and 12 who have cut themselves and there are children as young as nine who are self-harming in other ways, through eating disorders, alcohol or drugs. The problems have definitely increased since I started working 16 years ago.

"There is so much pressure on children now; pressure to do well educationally, bullying and other problems like physical, emotional and sexual abuse."

Despite the rising rates of self-harm and other mental health problems among youngsters, specialist services have been among the worst hit by the funding problems facing the NHS.

Ms Nelson said there were currently no in-patient psychiatric beds for young people in Northern Ireland, even though the province had the highest rates of young male suicides in the UK.

Chris Etherington, a school nurse, told a debate on self-harm that only 12.5 per cent of children aged 11 to 16 who deliberately cut themselves sought medical help for their problem because they felt ashamed and scared of the consequences.

She said: "Sometimes it is their life experiences and trauma that has taught them to use these methods of coping and we need to give them new ways of feeling emotion. One young person told me: 'Cutting lets me feel something. When I do this it lets something out.'"

However, nurses and the rest of the medical establishment are divided over the way in which to deal with patients who self-harm.

Some members of the RCN have called for the code of conduct set out by their regulatory agency, the Nursing and Midwifery Council (NMC), to be revised to allow them to help some adult patients.

The code of conduct prohibits nurses from doing anything that is detrimental to the well-being of the patient, but some delegates at the conference said banning people under their care from cutting themselves could do more harm than good.

The Department of Health is funding a pilot project at St George's psychiatric hospital in Stafford that allows some in-patients to cut themselves as part of their care plan. The plan was agreed with the medical team treating them.

Chris Holley, who is involved with the project, said: "It is controversial but this is not about all people who self-harm and it is not about handing out cutting implements.

"It is about people who self-injure in order to manage their feelings and to help them live, rather than die."

She compared the practice with handing out clean syringes to drug addicts.

The RCN is considering discussions with the NMC about whether the code of conduct could be changed to allow "therapeutic risk-taking".

There are no current plans to extend the project to children.