Help-seeking before and after episodes of self-harm: a descriptive study in school pupils in England

Background: Deliberate self-harm in young people is a cause for concern in many countries. The vast majority of episodes of self-harm do not result in presentation to hospital and relatively little is known about to whom or where adolescents who harm themselves go for help. Methods: This school-based survey of 5,293 15-16 year olds in the United Kingdom investigated sources of help and barriers to help seeking before and after an episode of self-harm. Results: Friends (40%) and family (11%) were the main sources of support. Far fewer adolescents had sought help from formal services or health professionals. Barriers to help seeking include perceptions of self-harm as something done on the spur of the moment and therefore not serious or important or to be dwelt upon. Many adolescents felt they should be able to, or could cope on their own and feared that seeking help would create more problems for them and hurt people they cared about or lead to them being labelled as an 'attention seeker'. The decision to seek help was in some cases hampered by not knowing whom to ask for help. Gender and exposure to self-harm in the peer group influenced perceived barriers to help-seeking. Conclusion: There are both push and pull factors' acting on young people in their understanding of what leads them to want to harm themselves and potential mechanisms for seeking help. The implications for community based prevention programmes are discussed.