Self-Harm & Suicide Issue – Foreword from the Editor

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I am a Consultant Child and Adolescent Psychiatrist working clinically in a North Yorkshire CAMHS team. I am Associate Director of Medical Education in the trust I work in, also Training Program director for CAMHS higher training in Yorkshire.

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This edition of the Bridge focuses on self-harm and suicide research in young people. As a clinician, it certainly does feel that more and more young people are being referred, following self-harm or with suicidal ideas, to the CAMHS service I work in. This nationwide increase in numbers is acknowledged in recent government reports, which are summarised in this edition.

Cha et al. highlight that the prevalence of suicidal ideation in young people between the ages of 10 and 17 lies somewhere between 19 and 24%. Orchard et al. found, that in the young people diagnosed with depressive disorder in their study, suicidal ideation was present in 86%. This certainly fits with my experience of the young people who I see in clinic who meet ICD10 criteria for depressive disorder of moderate severity, in whom suicidal ideation is common. This symptom can be very frightening for young people and their parents and carers and the assessment and management of suicide risk in young people can present a challenge for professionals and families.

The New Models of care initiative hopes to prevent young people being admitted to hospital, by supporting enhanced community provision. CAMHS staff do have the principles of harm minimisation and structured clinical judgement (Best Practice in managing Risk DOH 2007) to guide them in decision making and care planning. However, Orchard et al. do comment on the emotional burden to carers and staff of managing this degree of risk on a day to day basis.  Stewart et al’s. work highlights the importance of involving and supporting parents and carers of young people who have self-harmed or who feel suicidal.

In my experience this partnership working is essential to safely manage risk and to help young people recover. The work of third sector partner PAPYRUS is also described in this edition. PAPYRUS was founded by people with a lived experience of young suicide and highlights that suicide is everyone’s business and that the whole community should be concerned about it. The charity’s ‘spot the signs’ campaign, encourages those in contact with young people to ask them directly about suicidal ideas, if they are worried about them, so that talking can be encouraged and help can be sought. There is a lot more information and support for young people, carers and professionals on the PAPYRUS website.

This pdf has some of the articles from the Self-harm and Suicide issue of The Bridge, please feel free to share this and the direct links below with colleagues. I hope you find this edition helpful.

Articles from this edition

Machine learning approach predicts suicide risk

Violent self-harm may predict subsequent suicide

PAPYRUS – working for prevention of suicide in young people

Navigating an unfamiliar world: how parents of young people that self-harm experience support and treatment

Place children and young people at the heart of the strategy – A call by a recent joint UK Select Committee

Suicide risk in the young: what, how and who to study

The family environment mediates risk of self-harming

Clinical characteristics of adolescents referred for treatment of depressive disorders

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