Concern as self-harm hospital cases 'rise 50%'

The number of young people admitted to hospital after cutting themselves deliberately is up by more than 50% in five years, according to new figures.

There were 2,727 admissions in the UK for self-harm with a sharp object among under-25s in 2008/9, compared with 1,758 in 2004/5.

"We are sure this is just the tip of the iceberg," said Professor Keith Hawton at Oxford University.

"Pressures have increased and there's much more expected of young people."

"Another factor could be publicity," he added. "It's being discussed more in the media and by that I include the internet."

One in five school children with a history of self-harming questioned by researchers at Oxford and Stirling Universities said they first learnt about it after seeing or reading something online, second only to hearing about it from friends.

The Royal College of Psychiatrists says it is now "seriously concerned" about the growing number of websites which glamorise the problem or show gory images of cuts and scars.

"The kinds of things we are worried about are the graphic videos of self-harm [injuries] that are posted to sites like YouTube," said Dr Margaret Murphy, chair of the College's child and adolescent section.

"Young people tell us that images can trigger memories and that makes them much more likely to self-harm."

Online safety

The Royal College of Psychiatrists is now calling for websites owners and moderators to remove material which might promote or trigger self-harm and to link directly to sites which offer professional support.

Tens of thousands of videos dealing with self harm and cutting have been uploaded to sites like YouTube.

Some offer genuine help and advice but a growing number feature graphic photos and moving images of cuts and scars often along with background music and personal comments.

The most popular have been viewed more than 300,000 times and generate dozens of comments each day.

"I think the internet played a major role; I think it started off my self-harm," said Danielle, 17, from Belfast. "I was already thinking about it so went to the web to find out more."

"I just typed 'self-harm' and there were hundreds of videos. Some are good but others can be very damaging. If I see a picture [of cuts], it can encourage me to do it. Sometimes it's a competitive thing."

Tens of thousands of videos dealing with self-harm and cutting have been uploaded to sites like YouTube.

Some offer genuine help and advice but a growing number feature graphic photos and moving images of cuts and scars often along with background music and personal comments.

The most popular have been viewed more than 300,000 times and generate dozens of comments each day.

Forums

YouTube, which is owned by Google, says it will take down graphic material but only if those videos deliberately tell or encourage other young people to self-harm.

"Our policies try to strike the right balance between enabling people to talk honestly about the issues they have faced, but prohibiting videos that actively encourage dangerous acts," said a spokesman.

"When people see content they think is inappropriate they can flag it and our staff then review it. If the content breaks out terms then we remove it and if a user repeatedly breaks the rules we disable their account."

Elsewhere on the internet, dozens of forums let young people who self-harm chat about their experiences and feelings online.

Many are well run with a high level of moderation and support.

But doctors say there is a danger that some can promote a dependency or encourage competition to cut in a similar way to pro-anorexia sites.

"At the time I would say they were helpful; but looking back not so helpful," said Heather, 23, who stopped self-harming two years ago.

"I can see how they influenced my self-harm and some points it escalated when I was using them.

"If I was trying to support somebody and they self-harmed then I would turn it back on myself and it would make me feel worse."

At the extreme end, a number of pro self-injury or 'pro-SI' groups feature advice on how to self-harm and allow users to post photos of their own injuries.

Mental health charities and psychiatrists now want to see better training for teachers and staff in A&E departments to deal with self-harm.

"People are aware of this problem and starting to do something about it," said Professor Hawton at Oxford University.

"Teachers need to know about it and be well informed. When they discover it, as all will, they need to know they can handle it without freaking out."

A spokesman for the Department of Health said in a statement that the figures should not be looked at in isolation, insisting that self-harm and suicide rates had fallen. "National monitoring indicates that both self-harm rates and suicides are down in young people."

They added "Intentional self-harm is almost always a symptom of a complex mix of problems like mental illness, social exclusion and poverty. To further reduce self-harm we need to tackle the causes - and we're working hard to do that."