Self-harm may be increasing more quickly among young people from ethnic minorities

The study, which used data on hospital emergency department presentations across three cities and five hospitals for 10 –19-year-olds between 2000 to 2016, was published on September 21, 2021, in the journal, The Lancet Child and Adolescent Health.

The data that looked at increases in presentations over time found higher average annual increases of self-harm among Black and South Asian young people and those from other non-white ethnic groups compared to white young people. However, the researchers urge caution as the absolute increase in numbers, though statistically significant, was small. The findings might also have been accounted for by better recording or population changes.

And despite the increases, rates of self-harm remained highest in young people who were white.

The team analyzed the data from 10,211 white, 344 Black, 619 South Asian and 732 other non-white children and adolescents who presented for self-harm at emergency departments in Manchester, Oxford and Derby. The research was carried out as part of the Multicentre Study of Self-Harm in England.

Around half of Black, South Asian and other non-white young people received a specialist psychosocial assessment, compared to over 60% for white groups. Official guidance stipulates everyone who self-harms should be assessed.

Those from an ethnic minority background were more likely to live in economically deprived areas and less likely to be receiving mental health care than their white counterparts.

In terms of outcomes, the risk of repetition was lower among ethnic minority groups when compared to white groups. There was little difference in suicide mortality, but the overall number of suicide deaths was small.

Lead author Bushra Farooq, a researcher from the University’s Centre for Mental health and Safety, said: “Self-harm in all children and adolescents has become a major public health concern in recent years.

“While many presentations continue to be made by white children and adolescents, ethnic minority groups seem to account for an increasing proportion in recent years.

“It’s difficult to know what has driven this among ethnic minority groups specifically. Possible reasons include factors related to psychological health.

“Some people have also speculated that educational pressures or social media use might be driving the increase in young people as a whole, but the evidence is far from clear. We know social media can be helpful for some young people.”

“Increases after 2011 may also be associated with deprivation, poverty, and or service-related factors which might have particularly affected those living in poorer communities where a disproportionate number of ethnic minority groups live.”

“Unfortunately, our study could only look at very broad ethnic groups. Within these broad groups, there are some important differences. Future studies must acknowledge and explore these differences.”

The University of Manchester, the senior author on the paper, Professor Nav Kapur, added: “Historically, we haven’t had very good information on self-harm and suicide in people from ethnic minorities. Data on young people from these communities have been even more sparse.

“Of course, we must keep a close eye on the incidence of suicide and self-harm – the recent data published by the Office of National Statistics suggesting a high overall overate of suicide in people of mixed ethnicity emphasized just how important this is.

“But one of the big stories here is about inequity and access to services – young people from ethnic minority groups lived in more deprived areas, were less likely to be adequately assessed and less likely to receive mental health care.

“We need to understand the reasons for these findings and make sure we do better in the future, whether that is through the provision of culturally adapted mental health services or better staff training. We also need to stop thinking about people from ethnic minorities as part of a single group with uniform needs.”

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