Abstract
Objective: The aim of this study was to identify risk factors for self-harm for children and adolescents in a mental health inpatient unit.
Methods: A retrospective file audit of patient files over three years (2006–2009) was conducted to determine risk factors associated with self-harm in children and adolescents admitted to a mental health unit. A checklist of potential factors was based on risk factors found in a review of the literature including demographic information, diagnosis, home situation, environmental stressors, childhood trauma and previous mental health care. The study compared those who self-harmed with a control group who did not self-harm.
Results: There were 150 patients who self-harmed (mean age 14 years) and 56 patients who did not self-harm with a mean age of 13 years. Several factors were identified that increased the likelihood of self-harm, including a diagnosis of depression, female gender, increasing age, being Australian-born, living with a step parent, not having received previous mental health care, having a history of trauma, and having other stressors including problems within the family.
Conclusions: While increasing age, female gender, a history of trauma and a diagnosis of depression are well known as risk factors for self-harm, this study confirms that family factors, in particular living with a step parent, significantly add to the risk. Child and adolescent services should be aware of the increased risk of self-harm in young people with mental health problems who live in blended families. Treatment approaches need to involve parents as well as the child or young person.
Acknowledgements
We would like to thank Jenny Peat for her statistical advice and Lucres Nauta, the research supervisor of L.M. and E.B. at De Vrije Universiteit, the Netherlands.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.