Parents of children who self-harm often become
aware of the problem long before school or NHS services are
involved, prompting experts to call for greater support to help
parents understand and cope with self-harm.
Approximately 170,000 adolescents receive
hospital treatment for self-harm annually in the UK. However,
studies suggest that just 12% of self-harming episodes result in
hospital attendance, meaning the majority of episodes go
undetected.
Researchers from the Institute of Psychiatry,
King’s College London and the South London and Maudsley NHS
Foundation Trust interviewed twelve parents (nine mothers, two
fathers, one grandmother with a maternal role) of adolescents
receiving treatment for self-harm in community child and adolescent
mental health services (CAMHS) in Croydon, south London.
The
study, which is published in the August issue of the
British Journal of Psychiatry, is the first to investigate
parents’ perceptions of their children’s self-harm behaviour.
It showed that, in the months leading up to
self-harm disclosure, many parents had a suspicion about their
child’s behaviour and often spotted injuries. However, when
confronted by their parents, the young people denied they were
self-harming and made excuses, such as saying the injuries were
inflicted by a pet. In general, the parents accepted their
children’s implausible explanations because they hoped that the
situation would resolve itself.
One parent, Mrs P, said: “We kind of brushed
it under the carpet…We try to ignore it really, to try to get on
with our life and hopefully she will stop doing it.”
In the study, formal confirmation of the
children’s self-harm mainly came from an outside agency – usually
school. However, the parents again found it hard to accept the
situation and did not push their children towards professional help
and advice. Most parents refused the initial offer of help,
accepting only the second or third. Help was usually only accepted
after an accumulation of other problems, such as bullying or
non-attendance at school. With hindsight, however, all parents who
participated in the study said they would advise others in their
situation to seek help sooner than they had done.
The study showed that parents found it
difficult to understand or empathise with their children’s
self-harming. Many saw self-harm as ‘a phase’ or ‘a fashionable
thing to do’. Another believed her daughter was ‘just copying her
friend’.
The researchers concluded that parents need
advice and support from outside services to help them manage
self-harming behaviour. Parents may be frequently recognising and
managing self-harm in the family home without input from schools or
health services. This means parents have a key role to play in
reaching self-harming children who are unknown to health
services.
Further research is needed to investigate
whether good advice and support, available from community resources
without necessitating NHS or school involvement, could help parents
to better understand, manage and cope with self-harm, decrease the
likelihood of deterioration and encourage parents to make
appropriate service contact earlier.
The study also showed that teachers and primary healthcare
practitioners ought to be aware of the needs of parents of
adolescents who self-harm – in particular, parents’ feelings of
helplessness and desire for advice.