Government policy on deliberate self-harm and suicide prevention is guided by our national strategy Reach Out which makes a number of recommendations in relation to fast track referrals to community-based mental health services, effective response to deliberate self-harm, training, reducing stigma and promoting positive mental health, initiatives aimed at helping young men and research. The HSE’s National Office for Suicide Prevention (NOSP) has primary responsibility for the implementation of Reach Out. I would like to assure the Deputy that dealing with the current high levels of suicide and deliberate self harm is a priority for this Government.
The National Suicide Research Foundation (NSRF), which is funded by the NOSP operates the National Registry of Deliberate Self Harm. This is a national system which monitors the occurrence of deliberate self-harm presenting to hospital Emergency Departments. The NSRF compiles and publishes data on the incidence of deliberate self harm an annual basis. Data on the reasons behind the presentation of deliberate self-harm is not collected.
A Child and Adolescent Self-Harm in Europe (CASE) study which was carried out in Ireland and in six other centres in Europe and Australia aimed to establish the prevalence and correlates of self-harm among adolescents aged 15-17 years. The study found that the common factors significantly associated with self-harm among young boys and girls in Ireland were having a friend who engaged in self-harm and drug use. Among girls, having lower self-esteem experiencing problems making friends or keeping friends and conflict with parents were also associated with deliberate self-harm. Having a family member who had engaged in deliberate self-harm and experience of forced sexual activity were also significant for girls.
Deliberate self-harm in boys was significantly associated with higher levels of anxiety and impulsivity, problems with schoolwork and having experienced bullying at school. Among boys who had experienced bullying, other factors increasing the risk of self-harm included worries about sexual orientation, physical abuse, and problems with school work. Risk of lifetime self-harm was four times higher for boys who experienced bullying in school.
Drawing from the CASE study data from the seven countries, Madge at al (2011), found that there was a weak association between being bullied and deliberate self-harm. The researchers concluded that there is no single pattern of self-harm among young people, but both psychological characteristics and stressful life events substantially increase risk. The NOSP is currently funding a literature review to examine the prevalence and impact of cyber bulling on mental health and suicidal behaviour. This literature review addresses Action 11 of the Department of Education and Skills Action Plan on Bullying (2013). The literature seems to suggest that cyber bullying alone does not lead to deliberate self-harm or suicidal ideation, but cyber bullying may increase depression in young people, and thereby exacerbate vulnerabilities which increase the risk of deliberate self-harm and suicidal ideation. Emergency Departments have the expertise in deliberate self-harm, crisis intervention nurses and/or liaison psychiatry services to support anyone who attends after an episode of self-harm.
