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G129 ‘When things get on top of me....’A retrospective study of deliberate self - harm in children aged below 14 years
  1. V Rao1,
  2. A Dave2
  1. 1Paediatrics and Child Health, Walsall Healthcare NHS Trust, Walsall, UK
  2. 2Child and Adolescent Mental Health Service, Dudley and Walsall Mental Health Trust, Walsall, UK


Introduction Deliberate self harm (DSH) is a major public health issue affecting 1 in 15 young people in the UK. Madge et al (2008) reported that over 70% of 15–16 year-olds admitted to self-harming at some stage in their lives. There is very little information on DSH in children aged below 14 years.

Aim To study the basic epidemiology of DSH in children aged under 14 years.

Method Children under 14 who were admitted to hospital for DSH over a 2 year period were included. Data was collected from clinical records of the Child and Adolescent Mental Health Service (CAMHS)

Results Of the district’s child population of 70,000, 186 children under 17 years of age (41 boys and 145 girls) were admitted with DSH. 18 (10.5%) of these were under 14 (11 boys and 7 girls). The results apply to this group.

Age distribution Image 1

Abstract G129 Image 1

– age distribution

15 White British; 4 looked after.

In 4 children there had been a previous admission for DSH, and in one child there had been 2 previous attempts in the same 2-year period. A further 10 children reported attempts at DSH prior to this period.

There was a family history of depression in 3 cases, schizophrenia in 1, one attempted suicide in 1 case and a completed suicide in 1 case.

4 children had autism spectrum disorder, one had ADHD and 1 had cerebral palsy

6 were already under CAMHS.

Reasons for DSHImage 2

Abstract G129 Image 2

– Reasons for DSH

Methodof DSHImage 3

Abstract G129 Image 3

– Methods of DSH


  • 10% of children who self harmed were under 14,

  • bullying, school difficulties, family problems were the common reasons for DSH

  • overdose was the commonest method; many threatened to self harm with a knife or attempted self strangulation.

  • most children had tried DSH in the past and 5 in the last 2 years.

  • a third had neurodisability,

  • a third had a family history of mental illness.

Conclusions It is of great concern that some children as young as 8 and 9 self harm. There are no universal screening tests to assess risk of DSH in children. Professionals working with children and adults need to adopt a ‘whole-family’ approach even if either present initially to services. Schools need to have and adhere to robust anti-bullying policies.

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