Background: Deliberate self harm is major public health problem, in particular among young people. Although several studies have addressed the prevalence of deliberate self harm among young people in the community, little is known about the extent to which deliberate self harm comes to the attention of medical services, the self harm methods used and the underlying motives. The aim of this study was to determine the prevalence of deliberate self harm in adolescents and the methods, motives and help seeking behaviour associated with this behaviour.

Methods: A cross-sectional survey using an anonymous self-report questionnaire was administered in 39 schools in the Southern area of the Health Service Executive, Ireland. Of the 4,583 adolescents aged 15-17 years who were invited to participate in the survey, 3,881 adolescents took part (response: 85%).

Results: A lifetime history of DSH was reported by 9.1% (n = 333) of the adolescents. DSH was more common among females (13.9%) than males (4.3%). Self cutting (66.0%) and overdose (35.2%) were the most common DSH methods. A minority of participants accessed medical services after engaging in DSH (15.3%).

The majority of the teenagers who engaged in self harm did so by either cutting themselves (66.0%) or taking an overdose (35.2%) (Table 3). Although there was a higher proportion of girls who reported cutting themselves or taking an overdose than boys, this was not significant. It is notable that boys used a greater variety of methods to harm themselves than girls. Of the 333 teenagers who had harmed themselves, 19.8% did so under the influence of alcohol, while 11.8% were under the influence of an illegal drug at the time when they harmed themselves. Boys (32.3%) were twice as likely as girls (15.4%) to have been under the influence of alcohol when they engaged in DSH (RR = 2.1, 95% CI: 1.3 – 3.4) and four and half times more likely to have taken an illegal drug (28.1% V 6.1%, RR = 4.6, 95% CI: 2.2 – 9.5). Of the 220 cases of self-cutting, 11.5% also involved an overdose.

Conclusion: DSH is a significant problem in Irish adolescents and the vast majority do not come to the attention of health services. Innovative solutions for prevention and intervention are required to tackle DSH in adolescents.