We must confront our fears and face up to this tragic epidemic of self-harm

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The Independent Online

Sometimes it takes one particularly tragic story to highlight a much wider problem and provide the impetus for a radical change in attitudes. The story of Sarah Lawson, a suicidal young woman who was repeatedly failed by the mental health services, should be one such case.

Sometimes it takes one particularly tragic story to highlight a much wider problem and provide the impetus for a radical change in attitudes. The story of Sarah Lawson, a suicidal young woman who was repeatedly failed by the mental health services, should be one such case.

Ms Lawson had suffered from manic depression for a decade, and during that time had deliberately harmed herself regularly. After these incidents turned into full-blown suicide attempts, her parents tried to place her in a secure psychiatric unit. Ms Lawson was eventually admitted to Homefields psychiatric hospital in Worthing, only to be ejected after one day for allegedly smoking cannabis. Her father, James Lawson, felt there was nowhere left to turn and suffocated his daughter in what has been described as a "mercy killing". He admitted manslaughter on the grounds of diminished responsibility and received a two-year suspended sentence.

A report into the affair by West Sussex social services and the Sussex Strategic Health Authority, published yesterday, points to several instances in which the social services and the NHS badly failed the Lawson family. Ms Lawson's treatment for depression was "fragmented" in the three years before her death. Information about her circumstances and case history was not passed on. No attempt was made to find out whether her parents were able to cope with caring for her. If it had been, the social services would have discovered that Mr Lawson himself had been diagnosed with depression and was in an increasingly desperate state of mind over his daughter. The report concludes that the quality of care Ms Lawson received was "generally of a high standard", but too often "poor". There can be no doubt that, at crucial times, it fell far below what was required.

That these failings resulted in such dire consequences should serve as a warning to all those involved in the provision of services for the mentally ill, in particular those who harm themselves. There are 170,000 people admitted to hospital each year as a result of self-harm, and the numbers are steadily growing. This is an astonishing figure, and the prospect that there are vulnerable people, like Ms Lawson, being denied the treatment and supervision they so badly need, is frightening.

An important aspect of the problem seems to be that, as with anorexia before the phenomenon became imprinted on the public consciousness, society does not understand why people self-harm. Often it is considered to be merely a fad, an attempt by young girls to attract attention. This attitude can even be found in the NHS. Some self-harmers have complained of being treated with contempt when they have turned up at accident and emergency departments. The speed with which Ms Lawson was ejected from hospital for smoking cannabis suggests a similarly dismissive attitude was a factor in her case, too.

The reality is that a propensity to self-harm is just as serious a condition as anorexia. Indeed, the two are often linked; when forced to eat, anorexics often resort to cutting themselves. Most self-harmers are young women. Institutions with harsh rules, such as the army and prisons, have seen an alarming spike in the number of cases. The notorious Deepcut barracks logged 59 instances of female self-harm between 1996 and 2001. Prisons, too, register a very high proportion of self-injury cases.

What leads people to deliberately harm themselves is still unclear. Many young people admit they do it because of insecurities over their bodies. It can also be an extreme symptom of clinical depression. Some psychiatrists identify it as a coping mechanism. But it is now manifestly clear that telling sufferers to "get a grip" is no way to tackle the problem. The mental health division of the NHS must start treating self-harm as a serious issue. Psychiatry and counselling must be made more readily available to sufferers. There can be no repeat of the failings that had such a tragic outcome for the Lawson family.

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