Background to the Research

• Large-scale survey data on the prevalence of self-injury among young people and their attitudes to self-harm and suicide has been available in England and Scotland, but not in NI. With a grant from the Nuffield Foundation, the 2008 YLT survey set out to fill this gap and to feed into policymaking and formulation in the area of mental health provision for young people.
  

Research Approach

• Every 16-year old living in NI who was born in February and March and registered to receive Child Benefit was invited to take part in the survey. 941 respondents completed the YLT survey. Respondents were initially asked three questions in relation to their mental and emotional wellbeing and self-harm: whether they had at some point in the past suffered from serious personal, emotional, behavioural or mental health problems for which they felt they needed professional help; whether in the past they had seriously thought about taking an overdose or harming themselves; and whether they had actually done so.
  

Main Findings

• 75% of respondents reported that they had not had problems for which they thought they needed professional help. Thus, 25% of respondents had experienced serious personal, emotional or mental health problems, but only 9% of respondents had sought professional help for these problems. 14% of respondents said they had in the past seriously thought about taking an overdose or harming themselves and 10% said that they had actually done this.
• The prevalence of reported mental and emotional health problems was significantly higher among females than males (71% and 80%). Females were also about two and a half times more likely than males to say that they had thought about self-harm (18% and 7% respectively) and to have actually self-harmed (13% and 5% respectively).
• Respondents from financially not-well off family backgrounds were significantly more likely than their better-off counterparts to report personal, emotional or mental health problems and to have thought about self-harm and twice as likely to have taken an overdose or tried to harm themselves as respondents who came from well-off backgrounds.
• 42% of females from not-well off backgrounds said that they had suffered from emotional and mental health problems for which they thought they needed professional help. This compares with just 19% of males from well-off backgrounds who were the group least likely to report such problems. 18% of females from not well-off backgrounds had tried to harm themselves, six times the proportion of well-off males (3%).
• There was no statistically significant difference between respondents attending different school types in relation to considered self-injury and actual self-injury. In terms of the religious background, Protestants (7%) and Catholics (10%) were less likely to say that they had tried to harm themselves or taken an overdose than respondents with no religion (15%).
• Overdosing by tablets and cutting were the two main reported means of self-injury. The most likely reason why 16-year olds said they harmed themselves was that they wanted to punish themselves (55%).
• Emotional and mental health problems and self-injury were associated with high levels of reported stress, experience of school bullying and experience of social pressures. The workload in school was the by far the most often named stressor and many comments associated academic pressure and stress to poor mental and emotional health.
• Respondents who had self-harmed were over three times more likely than those who had not to say that they felt pressurised to take illegal drugs (26% and 8%) and to have sexual intercourse (31% and 9%). Respondents who had reported emotional and mental health problems and episodes of self-harm were also much less likely to have abstained from health-adverse behaviour.
• Mental and emotional health problems were also associated with school bullying. One third of respondents who did not report mental and emotional health problems had been bullied in school compared with half of respondents who did; 65% of 16-year olds who had self-harmed had also been bullied in school.
• There was evidence that, when worried or upset, 16-year olds with mental and emotional health problems use more destructive and non-communicative coping mechanisms. Friends were the most likely source of support for respondents when they were worried or upset; those with emotional and mental health problems were less likely to say they could talk to their friends or to their mother than their counterparts. Fathers were the least likely source of support.
• Overall, respondents with mental and emotional health problems were much less resourceful in dealing with worry or stress. Four main barriers to seeking support were identified as: feeling they didn't need support; feeling embarrassed or ashamed; fear of being seen as attention seeking or a burden; and being unable to discuss their problems.
• Whilst 63% of respondents agreed that most young people who harm themselves are lonely and depressed, only 19% felt that people who self-injure are mentally ill. There was a strong sense that self-injury could be prevented (64% agreeing), but an even stronger sense that people who harm themselves feel hurt inside (83%).
• 39% of respondents agreed that young people who self-harm try to get attention.
• The predominant tenor of the comments was that young people are under a lot of pressure and stress and that adults underestimate or fail to understand this - even contributing to a stigmatisation of the subject.
• There was a strong sense that 16-year olds see the need for better mental health services and support to address the issue of self-injury.