Mental health professionals are calling for an up-to-date survey to discover the number of teenagers who are self-harming in Scotland, with strong anecdotal evidence suggesting there has been a rise since the last comprehensive study of Scottish adolescents in 2009.
The five-year-old report found 20 per cent of schoolgirls in S4 and S5 had deliberately hurt themselves at one point in their lives, with the majority having done so in the previous 12 months. More than one in ten of all of the 2,000 pupils surveyed had self-harmed, which can take the form of cutting and burning but can include a variety of other methods designed to relieve the stress the individual is feeling.
Report author Professor Rory O'Connor, of the University of Glasgow, who sat on the development group for the NICE self-harm guidelines, believes the numbers are rising as the figures of young self-harmers across the UK being hospitalised are on the increase, but would like evidence to support this theory: " We just don't know because there has been no large-scale follow-up research. What we need is another survey which would be representative of the population of adolescents."
He added that if the scale of the problem was quantified, then mental health services would be better able to tackle it: "We need to do much more research to monitor the rates of self-harm because it is an indication of distress in itself and we know that people who self-harm are at risk of a range of other issues when they are older.
"These adolescents don't realise they are going to have to live with their scars in later life. We have a duty to our young people to help them in whatever way we can to stop self-harming. If we can identify them sooner, hopefully the opportunities for intervention are greater."
Whilst most adolescents who deliberately injure themselves stop by their mid-twenties, those whose wounds lead to hospitalisation are at a greater risk of dying by suicide in the future: "The challenge is there is rarely a single motive that underpins self-harm, for example when we worked with 2,000 adolescents 40 per cent said that one of the motives was they wanted to die, yet many people self-harm as it keeps them alive; the motives are complex."
Professor O'Connor urges caution over suggestions Goths, Emos or punks are more likely to harm themselves than other teenagers - as was suggested by one study - adding that self-harming has many causes: "It is important that we don't reduce self-harm to one type of behaviour; it is a manifestation of distress and that distress can have many factors. It's a way of coping or managing their own distress. Many young people say they self- harm as it is a way of making the pain they experience in their mind real, and it is a way of coping with that distress."
Heather Sloan, health improvement lead of mental health for NHS Greater Glasgow and Clyde, supports Professor O'Connor's call for up-to-date figures as she finds the numbers quoted deceptive: "Some figures which are bandied about are misleading, such as the one-in-15 quoted by the Mental Health Foundation, which only records hospital admissions and is just the tip of the iceberg."
She added accurate figures would allow the NHS to resource the necessary services and allow professionals who work with young people an idea of the extent of the problem. In the last 18 months her organisation has been inundated with calls from schools looking for ways to support young people who are self-harming, with hundreds of professionals on a waiting list to go onto courses training them in how to support self-harming pupils.
However, there are not enough staff to deliver the training: "We are in the process of training the trainers as we don't have the capacity to cope with the demand for places to deliver the training. We could fill a course every day of the week and still be oversubscribed with demand for it."
In response to the demand from teachers for support, the On Edge educational pack was created over a two-year period and launched in March. The materials are not only a set of lessons, but also offers advice to those worried a friend or pupil could be self-harming. These include such tips as directing the young person to the right professional help while not breaking their confidence, nor asking to look at their scars or telling them to just stop self-harming.
Lisa Aitken, a young person's resource worker for Renfrewshire Council, who led the working group which developed the resource, said: "The pack is designed to dispel some of the myths while exploring a range of behaviours which could be harmful. It also aims to increase the understanding of the function of self-harm to let young people know they are not 'mental', and also to remove the barriers to let them know there is help out there and where they should go to get that help.
"It's about harm reduction, keeping safe and knowing there are dangers. It's about signposting them to know where they can go to keep themselves safe."
She added: "We launched in March 2014 and since then the key players involved have been inundated with requests for the pack; the demand has been unbelievable."