The barriers and facilitators to the reporting and recording of self-harm in young people aged 18 and under: a systematic review

Abstract

Background and aims This systematic review sought to identify, explain and interpret the prominent or recurring themes relating to the barriers and facilitators of reporting and recording of self-harm in young people across different settings, such as the healthcare setting, schools and the criminal justice setting. Methods A search strategy was developed to ensure all relevant literature around the reporting and recording of self-harm in young people was obtained. Literature searches were conducted in six databases and a grey literature search of policy documents and relevant material was also conducted. Due to the range of available literature, both quantitative and qualitative methodologies were considered for inclusion. Results Following the completion of the literature searches and sifting, nineteen papers were eligible for inclusion. Facilitators to reporting self-harm across the different settings were found to be recognising self-harm behaviours, using passive screening, training and experience, positive communication, and safe, private information sharing. Barriers to reporting self-harm included confidentiality concerns, negative perceptions of young people, communication difficulties, stigma, staff lacking knowledge around self-harm, and a lack of time, money and resources. Facilitators to recording self-harm across the different settings included being open to discussing what is recorded, services working together and co-ordinated help. Barriers to recording self-harm were mainly around stigma, the information being recorded and the ability of staff being able to do so, and their length of professional experience. Conclusion Following the review of the current evidence, it was apparent that there was still progress to be made to improve the reporting and recording of self-harm in young people, across the different settings. Future work should concentrate on better understanding the facilitators, whilst aiming to ameliorate the barriers.

Risk rates and profiles at intake in Child and Adolescent Mental Health Services (CAMHS): A cohort and latent class analyses of 21,688 young people in South London

“…Therefore, it is noteworthy that we did not observe a class characterised by maltreatment and self-harm specifically. This may reflect a methodological limitation given this is a risk assessment based upon the first assessment and several lines of evidence suggest that CYP generally experience various barriers to discussing self-harm with professionals (Waller et al, 2023).…”

Do young people who self-harm experience cognitions and emotions related to post-traumatic growth?

“…Public Health England (2020) report over 100,000 hospital admissions each year in England as a result of self-harm. These figures are likely to be an underestimate as many individuals who self-harm do hide it owing to the stigma around self-harm being an attention-seeking behaviour, and patient's concerns around potential breaches of confidentiality if individuals do report self-harm ( Rowe et al., 2014 ; Waller et al 2023 ).…”