Self-Harm

Suicide is the second leading cause of death in adolescents in most Western countries. Self-harm is the strongest predictor of eventual death by suicide in adolescence, increasing the risk up to ten-fold. Self-harm is a common and a growing problem. Around 10% of adolescents will have self-harmed by the time they finish school. 

Despite the high prevalence there is no agreement about the definition of self-harm, specifically the role of suicidal intent in defining self-harm sub-types. Consequently, there are few clinically relevant screening and assessment tools for adolescent self-harm. 

Despite these fundamental gaps in theory, a range of intervention and prevention studies have shown effects in reducing self-harm ideation and behaviour in adolescents. However, poor adherence to follow-up is a major obstacle in providing practical help to adolescents who self-harm. Around 25-50% of the adolescents who engage in self harm are likely not to attend any follow-up sessions. 

A range of studies conducted in collaboration with Imperial College London, South London and Maudsley NHS Foundation Trust and Tavistock and Portman NHS Foundation Trust seek to address these problems. Specifically, we investigate the long-term impact of Therapeutic Assessment, a brief intervention for young people presenting with self-harm in emergency settings designed to improve engagement with clinical services; develop a modular psychotherapeutic intervention for young people with self-harm; explore prevention of self-harm by evaluating an intensive mental health intervention for 0-5-year-old looked after children; develop and evaluate the efficacy of 
Supported Discharge Service, a service model for young people with self-harm and severe mental health disorders; and extend our understanding of the basic physiology of self-harm by exploring the pain sensitivity of young people both with and at risk of self-harm.