Researchers surveyed over 6,000 pupils aged 15 and 16 years from 41 schools in England. The questionnaire was anonymous and sought information about lifestyle, deliberate self harm, suicidal thoughts, and self esteem. Reported acts of self harm were assessed according to specific criteria.
Overall, 398 pupils (7%) had carried out an act of deliberate self harm in the previous year that met study criteria. However, only 13% of episodes had resulted in presentation to hospital. Deliberate self harm was nearly four times more common in females than in males.
In females, the factors associated with deliberate self harm included recent self harm by friends or family members, drug misuse, depression, anxiety, impulsivity, and low self esteem. In males the factors were suicidal behaviour in friends and family members, drug use, and low self esteem.
These findings support the need for school based mental health initiatives, targeting self esteem issues, depression, anxiety, and impulsivity, say the authors. Further potential approaches could include educating school pupils about mental health problems and routine screening for those at risk.