Deliberate Self-harm in Adolescence

146 Pages·2004·0.68 MB·English

by  Claudine Fox

Deliberate Self-Harm in Adolescence
Child and Adolescent Mental Health Series
Writtenforprofessionals,andparents,theseaccessible,evidence-basedresources
areessentialreadingforanyoneseekingtounderstandandpromotechildrenand
young people’s mental health. Drawing on the work of FOCUS, a
multidisciplinary project based at the Royal College of Psychiatrists’ Research
Unit,eachtitleintheseriesbringstogetherpracticalandpolicy-levelsuggestions
withup-to-the-minuteanalysisof research.
alsointheseries
Mental Health Services for Minority Ethnic Children and Adolescents
EditedbyMhemoodaMalekandCarolJoughin
ForewordbyKedarNathDwivedi
ISBN1843102366
ChildandAdolescentMentalHealthseries
Deliberate Self-Harm
in Adolescence
Claudine Fox and Keith Hawton
TheRoyalCollegeof
Psychiatrists’ResearchUnit
Jessica Kingsley Publishers
London and Philadelphia
Extracts on pp.12, 25 & 67 reproduced with permission from H. Spandler (1996)Who’s Hurting
Who? YoungPeople, Self-harm and Suicide.Manchester: 42nd Street Copyright © 42nd Street, 1996.
Extracts on pp.13, 18 & 67 reproduced with permission from YoungMinds (2003)Worried about
Self-injury?London: YoungMinds. Copyright © YoungMinds 2003.
Extract on p.14 and Box 7.1 reproduced with permission from K. Hawton and K. van Heeringen
(eds) (2000)The International Handbook ofSuicide and Attempted Suicide.
Copyright © 2000 John Wiley and Sons Limited.
Extracts on p.59 reproduced with permission from Royal College ofPsychiatrists (1998) Managing
Deliberate Self-Harm in Young People. Council Report CR64. London: Gaskell Publications.
Copyright © Royal College ofPsychiatrists 1998.
All rights reserved. No part ofthis publication may be reproduced in any material form (including
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First published in the United Kingdom in 2004
by Jessica Kingsley Publishers
116 Pentonville Road
London N1 9JB, UK
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA
www.jkp.com
Copyright © The Royal College ofPsychiatrists 2004
Library ofCongress Cataloging in Publication Data
Fox, Claudine.
Deliberate self-harm in adolescence / Claudine Fox and Keith Hawton.— 1st American pbk. ed.
p. cm. — (Child and adolescent mental health series)
Includes bibliographical references and index.
ISBN 1-84310-237-4 (pbk.)
1. Self-destructive behavior in adolescence. 2. Teenagers—Suicidal behavior. 3. Youth—Suicidal
behavior. I. Hawton, Keith, 1942- II. Title. III. Series.
RJ506.S39F69 2004
616.85’82’00835—dc22
2004012456
British Library Cataloguing in Publication Data
A CIP catalogue record for this book is available from the British Library
ISBN-13: 978 1 84310 237 3
ISBN-10: 1 84310 237 4
ISBN pdfeBook: 1 84642 016 4
Printed and Bound in Great Britain by
Athenaeum Press, Gateshead, Tyne and Wear
Contents
Acknowledgements 8
Preface 9
1
Introduction 11
2
The Prevalence of Suicidal Behaviour in
Adolescence 17
Deliberate self-harm in adolescents:
Oxford patient data 19
Deliberate self-harm in adolescents: national
survey data 21
Summary points 24
3
Risk Factors for Adolescent Suicidal
Behaviour 25
Models of suicidal behaviour 27
Personal characteristics as risk factors 29
Psychiatric disorders as risk factors 31
Family risk factors 39
The media 40
Summary points 42
4
Identifying At-Risk Adolescents 44
Screening instruments for the identification of at-risk
individuals 45
Summary points 57
5
Services for Adolescents 59
Commissioning services 59
Delivering services 60
Summary points 62
6
The Outcome of Suicidal Behaviour in
Adolescence 63
Child to adult follow-up 63
Summary points 66
7
Managing Adolescent Suicidal Behaviour 67
Immediate and general hospital management 67
Aftercare 70
The efficacy of aftercare and its outcome 76
Summary points 80
8
Preventing Adolescent Suicidal Behaviour 82
School-based educational suicide prevention
programmes 82
Screening programmes for at-risk individuals
in schools 86
Weapon control 86
Crisis intervention centres 87
Reduction of substance abuse 87
More responsible media reporting 88
Prevention of repetition of self-harm 88
Summary points 89
9
Future Prospects 90
Conclusions 90
Messages to take away 94
Future research 95
Resources 97
Appendix 98
Searchingtheliterature 98
Qualityofresearch 109
Criteriaforconsideringpapers 110
Criteriaforconsideringpapersforcriticalappraisal 110
References 123
Subject Index 137
Author Index 142
About FOCUS 144
Acknowledgements
FOCUSisgratefultoCarolJoughinandProfessorPhillipGrahamforproviding
adviceandcommentsondraftsof thisbook.
The FOCUS Project is funded by a grant from the Gatsby Charitable
FoundationandtheDepartmentof Health(Section64grantaward).