Dr Rhiannon Evans – Cardiff University
Self‐harm among adolescents is a major public health concern, with increased concern about growing rates. Self-harm is associated with a range of poor health, education and social care outcomes, including lower rates of educational attainment at age 16 years old and a higher risk of not being in education, employment, or training at 19 years old. However, those in full time education have been reported to be more likely to self‐harm, largely to cope with anxiety.
To date there is little evidence on effective approaches to self-harm prevention or intervention within the school setting. To develop more effective approaches, it is important to first understand the school environment, including barriers and facilitators of implementation and the acceptability of various intervention approaches.
A GW4 collaboration was funded to address school based approaches to self-harm and suicide prevention. GW4 seeks to encourage research collaboration between the universities of Cardiff, Bristol, Bath and Exeter. This particular collaboration was led from the DECIPHer research centre at Cardiff University. In order to address the identified research gap, the collaboration conducted a study to address the following research questions:
- How do secondary schools in England and Wales currently prevent or intervene with adolescent self‐harm?
- What prevention or intervention needs do secondary schools in England and Wales have in regard to adolescent self‐harm?
Data were collected from the bi-annual School Health Research Network (SHRN) survey in Wales and through a study specific survey in England. Two hundred and twenty two (n=222) secondary schools in England and Wales were invited to participate in a survey, with 68.9% of them taking part. One member of staff completed the survey on behalf of each school. Participants responded to questions on the existing provision of adolescent self‐harm prevention and intervention, barriers to delivery, and future needs.
- Emotional health and wellbeing is the primary health priority for schools, although self‐harm is also a concern.
- Counselling is seen as the most useful school‐based provision to respond to adolescent self‐
- Only 52% of schools have received staff training on self‐harm, with 22% of schools rating the adequacy of training as high.
- Key barriers to schools addressing adolescent self‐harm are: lack of time; lack of resources; lack of staff training and time; and fear of encouraging adolescents.
The findings provide a valuable insight into school approaches to self-harm and current barriers and facilitators to delivery.
The research has a number of key implications for policy and practice – with the team highlighting recommendations that can be used to make practical and positive changes.
First, there needs to be a consistent effort to provide high quality training support to school staff so that they are more confident to respond to disclosures of self‐harm.
Second, there remains limited capacity amongst mental health services to meet the needs of schools requiring external, specialist support. Investment is required to improve access.
Third, in order to support school‐level intervention, a coordinated policy approach needs to be adopted in order to ensure that sufficient resources are dedicated to adolescent mental health and well‐being and it is prioritised within this setting.
For further information and details on the research visit: https://onlinelibrary.wiley.com/doi/full/10.1111/camh.12308