Self-harm is a significant global public health issue that affects a large number of adolescents. In England alone, around 200,000 adolescents between the ages of 12 to 17 engage in self-harming behaviors every year without receiving clinical support. Additionally, approximately 21,000 adolescents seek medical treatment following self-harm incidents (Geulayov et al., 2018; Morgan et al., 2017; Patalay & Gage, 2019).
While rates of self-harm are higher among adults with disabilities (Khazem, 2018; Khurana et al., 2021), there are mixed findings regarding adolescents with disabilities (King et al., 2019; Tejera et al., 2019).
To contribute to advancing knowledge and understanding, this study was conducted to explore the prevalence and risk factors for self-harm in adolescents, both with and without disabilities.
Adults with disabilities are at higher risk of self-harm compared to those without – what about adolescents?
Methods
The researchers utilized secondary data from the Millennium Cohort Study, which included children born between 2000 and 2002 (Plewis et al., 2007). Participants were randomly selected using child benefit records, and data was collected through interviews with parents and adolescents at ages 14 and 17.
Disability was determined by a positive response to having physical or mental health conditions lasting 12 months or more, with further classification based on the level of functional limitation.
The study also assessed lifetime prevalence of self-harm at age 17 and 12-month prevalence of different self-harm behaviors, along with examining potential risk factors such as sexual orientation, bullying exposure, and self-reported depression at age 14.
Statistical techniques including inverse probability weighting and adjusted prevalence rate ratios were employed to analyze the data and compare the probability of self-harm among adolescents with disabilities to those without.
Results
Prevalence of disability
Out of the 9,528 participants aged 17:
- 12.4% reported some form of disability
- 7.7% had less limiting disabilities
- 4.7% had more limiting disabilities
Prevalence of self-harm
The lifetime prevalence of suicide attempts was significantly higher among adolescents with disabilities, with those experiencing more limiting disabilities having a much greater probability of attempting suicide compared to those without disabilities.
Functional impairments
Mental health and learning-related functional impairments showed a strong association with higher rates of self-harm, while impairments in vision and mobility did not exhibit significant links to self-harm behaviors.
Risk factors
Several risk factors were identified for self-harm prevalence among adolescents with and without disabilities, including gender, sexual orientation, socio-economic status, and depression.
This research suggests that adolescents with mental health and learning difficulties have a higher risk of self-harm.
Conclusions
The study underscores the heightened risk of self-harm and suicide attempts among adolescents with disabilities, particularly those with more severe limitations. The findings emphasize the need for targeted interventions and support services tailored to address the unique challenges faced by this population.
Being a LGBTQ+ adolescent with disabilities was identified as a key risk factor for self-harm.
Strengths and Limitations
The study’s strengths include addressing a crucial gap in the research by focusing on adolescents with disabilities and utilizing data from a nationally representative sample. However, limitations such as reliance on self-report data and the cross-sectional design impact the interpretation of results.
Future longitudinal research and consideration of additional factors such as school environment and family dynamics are warranted to further enhance our understanding of the relationship between disability and self-harm.
Longitudinal studies are required to better understand self-harm and disability among adolescents.
Implications for Practice
The study highlights the importance of mental health screening and support for adolescents with disabilities, particularly those with mental health and learning impairments. It underscores the need for anti-bullying initiatives and tailored interventions to address the unique challenges faced by this vulnerable population.
Further qualitative research and longitudinal studies are recommended to delve deeper into the experiences of adolescents with disabilities and develop targeted interventions to mitigate the risk of self-harm.
The study highlights a need for anti-bullying initiatives among adolescents to protect marginalized populations at higher risk of self-harm.
Statement of Interests
No conflict of interest.
Links
Primary Paper
Other References
Hawton K, Harriss L, Hall S, Simkin S, Bale E, Bond A. Deliberate self-harm in Oxford, 1990–2000: a time of change in patient characteristics. Psychological medicine. 2003;33(6):987-95.
