The number of young people self-harming is increasing with 22% of 15 year olds reporting that they had ever self-harmed, a report by Public Health England has found.
The report, based on data from the Health Behaviour in School-aged Children (HBSC) survey for England, 2014, found that over the past decade rates of self-harm have been increasing among adolescents. Nearly three times as many girls as boys reported that they had self-harmed (32% of girls compared to 11% of boys).
The majority of people who self-reported self-harm are aged between 11 and 25 years, however, self-harming behaviours are most likely to occur between the ages of 12 and 15 years. There are high levels of under-reporting around self-harm.
The HBSC findings indicated that the likelihood of self-harming varied by social-economic status and structure of households, with the incidence of self-harming associated with lower family affluence. Young people living in one-parent families – which is shown to be linked to lower-income households – were more likely to self-harm.
Thirty-five percent of 15 year olds who reported living with only one parent also reported having self-harmed, compared to 17% of those who lived in two-parent households.
Young people who felt that important things were discussed in their family, and that someone listened to them when they spoke, were less likely to report having ever self-harmed. Young people who demonstrated positive perceptions about their relationships with their school peers and classmates also reported lower levels of self-harming.
Among young people who reported ever self-harming about half reported that they had been bullied over the last two months, 49% reported experiencing traditional forms of bullying and 32% reported experiencing cyberbullying by messages. Among young people who reported never self-harming, about 24% reported experiencing traditional forms of bullying and 11% reported experiencing cyberbullying by messages.
Key positive health factors could help to decrease self-harming behaviour in adolescence. Young people who reported positive family communication, positive perceptions of the school environment and local neighbourhood were less likely to report self-harming.
“The protective nature of adolescents’ multiple environments (family, learning environment and wider community) can help to inform strategies to prevent self-harming behaviour among adolescents,” said the report.
Wellbeing of adolescent girls
A separate report by Public Health England but still based on the HSBC survey, summarised data on girls’ emotional health and wellbeing. It found that across a range of indicators of emotional health and wellbeing, girls reported poorer outcomes than boys and the gap widened from age 11 to 15 years.
Girls scored lower for life satisfaction than boys and this gender difference increased with age. Almost one fifth of 15 year old girls said they had felt lonely in the last week, compared to 7% of same age boys. Girls at all ages were more likely than boys to report experiencing multiple health complaints on a weekly basis and girls were less likely to participate in protective health behaviours than boys such as eating breakfast and taking regular exercise.
The study also found that girls were more likely than boys to say that they were ‘too fat,’ found communication with parents less easy than their male peers and were more likely than boys to rate their academic achievement as above average or feel pressured by school work.
Subjective life satisfaction was strongly associated with health outcomes, and girls with the lowest life satisfaction also had the poorest reported health outcomes.
“At an individual level, whilst behaviours such as balanced nutrition, regular physical activity, and sufficient sleep contribute to emotional as well as physical health and wellbeing, it would appear that girls that are most likely to self-report poor life satisfaction are those that are the least likely to engage in such healthy behaviours,” said the report.
“This may become a self-perpetuating cycle where positive self-care may become more difficult to engage in as emotional health diminishes meaning that girls in this group would need extra support for emotional health as well as for establishing positive health behaviours,” it added.
Promotion of healthy behaviours is likely to benefit girls regardless of socio-economic status, as is better availability of social support, the report adds.
A third report in the series based on the HSBC survey result on cyber-bullying found that in 2014, 17.9% of 11-15 year olds reported being cyberbullied in the two months prior to being surveyed.
Girls were twice as likely as boys to report being cyberbullied and cyberbullying increased with age for both boys and girls; the reported prevalence rates of cyberbullying at age 15 were almost double those for 11 year olds.
Young people from more affluent families were more likely to report being victims of cyberbullying and young people who reported positive family communication, especially with a father, were less likely to experience cyberbullying.
Receiving mean messages (including text, instant message, email) was slightly more common than being cyberbullied through images: 12.7% compared with 10%.
Young people who felt the important things were spoken about in their family and that someone listened to them when they spoke were less likely to say they have experienced cyberbullying in the past two months.
The report also highlighted that a supportive school culture and ethos has been associated with positive health and wellbeing outcomes for young people. Students overall sense of belonging to their school and their perception of safety within their school appear to be important factors associated with levels of bullying, including cyberbullying.
“The cross-sectional nature of the HBSC survey means we cannot assume cause and effect, however these analyses identify potentially protective factors from the key domains of young people’s environment (family, school and neighbourhood) which need to be considered when developing strategies to prevent cyberbullying,” said the third report. “The interaction between all three domains also needs to be considered, suggesting that multifactorial and multi-domain interventions could offer the most effective preventive or harm reduction strategies for cyberbullying,” the report concludes.
HBSC is a survey-based study conducted in collaboration with the WHO Regional Office for Europe. The survey examines the health and wellbeing, health behaviours and social environment of young people aged 11, 13 and 15 years in countries across Europe and North America.