Self-harm intervention is a vital part of suicide prevention for young people in care according to recent research from experts at the University of Nottingham.

In the UK and ROI, more than 6,000 people die by suicide a year - an average of 18 a day. The research is being highlighted as part of World Suicide Prevention Day on 10th September and has been led by Professor Ellen Townsend from the school of Psychology at the University of Nottingham.

The research published in the British Journal of Clinical Psychology is the first detailed study of factors leading to self-harm over time in young people in care in England, using the Card Sort Task for Self-Harm (CaTS) to describe sequences of factors leading to the young person’s first and most recent episodes of self-harm. This process provides young people with tools to map out thoughts, feelings and behaviours on a timeline leading up to, and immediately after a self-harm event. These can then be used to open up conversations and help formulate possible ways to help.

Analysis of the results from the Card Sort Task showed that young people in care felt better immediately after their first episode of self-harm with feelings of depression and sadness, and having the access to the means to self-harm, cited as key factors leading to self-harm. It also showed that sequences of factors leading to self-harm can change and evolve over time. Crucially, feeling better after self-harm disappeared over time and feelings of self-hatred and not being afraid of death emerged.

The conclusion was that regular monitoring and assessment of each self-harm episode are needed alongside support around easing and dealing with emotional distress.

Professor Townsend explained how the research emphasises the need for self-harm intervention: “Self-harm is the strongest predictor of eventual suicide and each suicide significantly affects many other individuals. Looked-after young people are at particularly high risk of self-harmful behaviour yet there is sparse research targeting this group.

“We know that talking about self-harm and suicide is extremely difficult, especially for those in care, which is where the CaTS system is very beneficial and would have clinical utility as an assessment tool as it provides a structured way to communicate and order thoughts and feelings in relation to self-harm. Providing effective support like this could make the vital difference for future positive outcomes and reduce incidences of self-harm and ultimately help prevent future suicide.”

Dr Ruth Wadman who conducted the work in the field said: “Young people told us that they enjoyed doing the CaTS. It gave them a way to understand their own self-harm and communicate about it effectively.”