Alarming Figures on Teenagers Self-Harming

One in ten teenagers (15-17) reported in their response to an anonymous questionnaire that they had either cut themselves or taken a drug overdose at least once.  Nearly fifty per cent of the 4,000 teenagers surveyed reported they had self-harmed more than once.  The two main reasons given were ‘I wanted relief for a terrible situation’ and ‘I wanted to die.’  What is distressing about the study’s findings is the high number of young people who are self-harming and the re-occurring fact that girls are three times more likely to self-harm than boys.  What is alarming about the reported figures is that eighty five per cent of the troubled teenagers did not seek help.  This non-reporting of inner turmoil is in keeping with previous research that showed that twenty to twenty-five per cent of teenagers have ‘undetected serious emotional turmoil.’  It also dovetails with a survey of university students on the prevalence of depression and their revealing that over two thirds sought no help and, significantly, one third who wanted to seek help, felt that no one would understand.  It would appear that having General Practitioners on the frontline for young people who are in distress is not working.  An explanation for this may be the growing trend among doctors to over-prescribe medication to children and adolescents.  Gerard Byrne, child and adolescent psychiatrist at the Lucena Clinic, Dublin is concerned that ‘the use of medication has become very much the area of the child psychiatrist.’  Hopefully, the recent findings on the ineffectiveness of anti-depressants and the astounding confession in 2007 by Dr. Robert Spitzer, Psychiatrist who ‘discovered’ ADHD, is that ninety per cent of the all the thousands of children who had been prescribed Ritalin or Concerta should never have been given these drugs.  He said that he had neglected to look at the contexts (the relationships) of the labelled children’s lives.  Dr. Byrne appears to be saying something very similar when he reported that ‘with methylphenidate (Ritalin), the recent research has shown that after about three years there’s very little effect and that you are much better off using other psychosocial interventions, such as interventions to correct disturbed attachments in children with ADHD and their families.’

The use of medication is often justified by the volume of individuals that need to be seen but this is too weak an explanation.  In any case, given the growing evidence of the serious limitations, not to mind the side-effects, of medications, for psycho-social problems in living, the maintenance of what has always been questionable practice is no longer tenable.  The illusion that there is a pill for every ill needs to be urgently challenged, as well as the growing trend of a pill for every thrill.

The reliance on medication for the treatment of childhood and adolescent distress sends a message to young people that there is something wrong with them and that it is biologically located.  Such an approach alienates young people who, sadly, are often alienated from themselves and from the significant adults and peers in their lives.  Dr. Byrne puts it well when he says: ‘You lose the emotional life of the child when you prescribe drugs because the child them becomes a very physical illness model, rather than trying to understand what the disturbances are and what is really wrong.’ Children and adolescents well know the sources of their distress and they know, too, the paucity of adults, professionally and lay alike, who are not in a place themselves to listen and understand.  All the indications are that this is true for General Practitioners.

It is the nature of what happens between people and within individuals that needs to be the focus of our attention.  The seeking of medical labels and prescriptions is a far cry from this essential caring response.  Significantly, other findings of the study on the prevalence of self-harming among teenagers support a psycho-social approach.  The study showed that conflict between children and parents, stress about school, relationship break-up between parents, problems with peers and with sexual identity and low self-esteem were significant contributing factors to self-harming.  I have said it many times that children and adolescents who act-out (for example, destructive, uncooperative, addicted to drugs or alcohol, school refusal) or act-in (shy, passive, timid, perfectionistic, withdrawn, isolated) are not trying to make life difficult for adults, but they are attempting in ways that are safest for them to let adults know how difficult life is for them.  No longer can we allow their symptoms (signals) be flown in vain.

Dr. Tony Humphreys practices clinical psychology and is author of several books on practical psychology, including All About Children.