Long-term support for self-harming children needed to reduce suicide risks, study warns

Research examines future risk of death for more than 9,000 youngsters taken to five hospitals in Manchester, Oxford and Derby

Self-harm is one of the most important risk factors for subsequent suicide in young people (Getty Images/iStockphoto)

Children who are taken to A&E departments after self-harming need long-term support and follow-up by the NHS to reduce the chances of suicide, experts have said.

A 16-year study found the risk of suicide in the first year after presenting to A&E among children was 30 times higher than the expected rate of suicide for the general population of similar-age youngsters in England.

Researchers said this risk remained at a similar level over more than 10 years.

Patients discharged from A&E should be referred for follow-up support from local mental health teams but concerns have been raised about the capacity of existing services with many NHS trusts restricting referrals only to the most severe cases.

The study, published in The Lancet Child and Adolescent Health journal, examined the future risk of death for more than 9,000 children, aged between 10 and 18, who were taken to five hospitals in Manchester, Oxford and Derby after self-harming.

The research, funded by the Department of Health and Social Care, found 55 children died as a result of suicide after being taken to hospital for self-harming.

Self-harm is one of the most important risk factors for subsequent suicide in young people. In the UK, suicide is the leading cause of death in people aged between 15 and 24, and general population rates of suicide have increased among people from 10 to 19 since 2010.

Lead author Professor Keith Hawton, from the Centre for Suicide Research at the University of Oxford, said: “Although our findings should be interpreted with caution, due to the relatively small number of deaths by suicide that occurred during the study, they emphasise a need to identify strategies to try to prevent self-harm in children and adolescents in order to reduce future risk of suicide.

“They also underline the importance of provision of good care for children and adolescents who present to hospital following self-harm.”

Within the 16-year follow up, the study found that 124 out of 9,173 young people had died.

Of the total 124 deaths recorded, 55 were due to suicide, while 27 were accidental and 42 were due to other causes.

The risk of suicide was greatest for boys, those who were in older adolescence when they presented to hospital, and those who repeatedly self-harmed.

Dr Galit Geulayov, from the University of Oxford, added: “Careful psychosocial assessment following presentation for self-harm is needed, including evaluation of the individual’s problems, needs and risk as specified in national guidelines, to plan appropriate follow-up care. This should also incorporate assessment for possible substance use.”

For confidential support call Samaritans on 116 123.

If you have been affected by this story, you can contact the following organisations for support:

https://www.mind.org.uk/

https://www.beateatingdisorders.org.uk/

http://www.nhs.uk/livewell/mentalhealth

https://www.mentalhealth.org.uk/

If you have been affected by sexual violence, you can find help via the NHS. Rape Crisis offers specialist support for women and girls; and the The Survivors’ Trust supports people of any gender.