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Why do so many children self-harm these days?

Young people who cut themselves are often dismissed as attention seekers but, says Kate Hilpern, their distress is real and their numbers are increasing

Last week, official statistics revealed an alarming rise in children who self-harm. These figures show that in the past year, NHS hospitals treated more than 18,000 girls and 4,600 boys between 10 and 19 after they had deliberately harmed themselves – a rise of 11%. During the same period, cases involving children between 10 and 14 rose from 4,008 to 5,192 – an increase of 30%.

According to Sarah Brennan, chief executive of YoungMinds, "an equally striking finding was the lack of confidence among parents and professionals about how to deal with it".

So what's going on? Why are so many young people – children, for goodness sake – self-harming? And where did the phenomenon, one that many people hadn't even heard of until recently, come from anyway?

Rachel Welch, project manager at selfharm.co.uk, isn't convinced self-harming is on the rise.

"If you think back," Welch says, "you may well remember someone in your youth who bit their nails furiously to the point of bleeding or who pulled out their hair. When I self-harmed as a teenager, I used bruising. Like these other people, I didn't think of it as self-harm, though, because the label wasn't around and there was no real understanding of it."

In turn, this meant other people were less likely to look out for, or notice, it.

But Sue Minto, head of ChildLine, believes the increase in cases has been dramatic. "In 2011-12, self-harm appeared for the first time in the top five main concerns for 14-year-olds. This dropped further to 13-year-olds in 2012-13, indicating that more young people are self-harming at a younger age," she says.

While some headlines have blamed a society increasingly obsessed with body image (which may help account for why girls are more prone to self-harming), Minto believes a more serious problem is the 24/7 online culture.

"In my day, if someone was bullied, they could find escape at home, but that isn't available now. Before you know it, something you said in confidence to one friend, or something unkind that someone else has said about you, is up there in neon lights for anyone to read for any amount of time."

While it's clearly positive that self-harm is now acknowledged as a problem, the increased publicity does have a darker side, Fiona Pienaar, head of service management at children's mental health charity Place2Be, says. "It means it is more likely to be on the menu of options for young people. I do wonder if some who hear about it and are struggling, may then try it."

With celebrities such as Demi Lovato, the US singer, increasingly making public that they self-harmed, it's a concept that is much more likely to be on a young person's radar, she explains.

Certainly, much is made of copycat self-harming, a concept that took a particularly sinister turn in January when a mock campaign started by online pranksters urged Justin Bieber fans to self-harm themselves and film it in protest at controversial images of the pop star.

There are even pro-self-harm websites, which Welch says are even darker than pro-anorexia ones. "These are not reasons to stop discussions around self-harm, however," she says. "In fact, I think the more we talk about it, the more likely prevention, support and treatment is likely to improve."

As it is, she says, there are countless problems. First off, prevention, which has to involve young people feeling they have positive engagement with their families, schools and peers, clearly isn't happening.

Second, while an adult facing mental health problems is likely to refer themselves to a doctor, youngsters almost never do until their symptoms are acute. It therefore falls to a parent or teacher, many of whom don't notice the problem.

"A further issue is that GPs often measure the emotional distress by the severity of the scars. But a 15-year-old cutting herself down to the bone isn't necessarily any more distressed than a 15-year-old scratching her wrist."

Even youngsters who do get referred often have an 18-week wait. "That's a long time for the problem to fester and they may no longer be in the right head space to talk about it."

Then there's the fact that youngsters need choices in treatment.

Indeed, if there is one piece of good news around self-harm, it's that most adolescents who self-harm will stop in early adulthood, and often abruptly.

"But this shouldn't be a reason not to take it seriously. It's a grave problem, with potentially fatal consequences, and some people continue or relapse," insists Welch.

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