26 - Self-harm

Summary

Self-harm is far more common than women realise, but it isn't talked about. Secrecy is the big enemy. We hope that this chapter will help women who use self-harm to understand more about their problems, to reduce or stop their self-harm and start their path to recovery, by ‘talking not harming’ and allowing themselves to feel supported by others.

What is self-harm?

Self-harm is when someone knowingly harms or injures themselves (Box 26.1). Some self-harm can cause immediate damage, other behaviours may be harmful in the longer term. Some people prefer the term self-injury. Other terms include deliberate self-harm or self-mutilation, but we urge people to stop using these terms – they are unhelpful, negative and contribute to stigma and judgemental attitudes. Words can make the pain worse and may delay the start of the healing and recovery process. Negative language can also discourage women from telling someone about their self-harm.

How common is self-harm?

Self-harm is an important health issue. It is more common in the UK than the rest of Europe. In the UK, approximately 6.5–8% of adolescents self-harm. This number drops to 4% in the adult population. Every year there are over 220 000 attendances at hospital due to self-harm. The highest rates of self-harm are among young Black and South Asian women (Cooper et al, 2010).

Box 26.1. Categories of self-harm

• Direct self-harm: an intentional act which causes immediate injury or harm to the body. No value judgement is made as to the motivation or degree of suicidal intent. This means it includes suicide attempts as well as acts where no suicidal intent is involved.

• Non-suicidal self-injury: a term used to describe self-injury which emphasises the wish to deal with emotional pain rather than as a means for suicide, thus making it clear and distinct from other direct and indirect self-harming behaviours.

• Indirect self-harm: covers a range of socially acceptable and unacceptable behaviours. These include smoking, drinking, drug-taking, eating disorders, and antisocial, risky, destructive and dangerous behaviours. As with direct self-harm, such behaviours are coping mechanisms to help deal with emotional distress; the frequency and danger increase as the distress worsens. These behaviours can be an indication that a person is in distress and could be at risk of more direct self-harm.