Key implications & recommendations

• The high rates of self-harm, and observed declines in mental health functioning over time indicate that greater prevention and early intervention work in this area is needed and that this should be a priority health objective.
• Adolescents appear to experience adversity across diverse social settings. It is crucial that adversity is defined and measured in a way that captures the wide array of challenges that teens experience across different social settings, to avoid underestimating the prevalence and impact of youth adversity.  
• The context in which young people experience adversity is important. Adolescents who experience adversity across multiple settings appear to be most at risk of self-harm and poor mental health outcomes, and should be a priority group for intervention and prevention.
• Protective factors operate at multiple levels. Adolescents should have access to supports across an array of community settings (e.g. parents, schools, peers) AND be encouraged to engage in positive health behaviours (e.g. sleep, physical activity). 

Key findings:

Adolescent Mental Health & Self-Harm

• Wellbeing and mental health among teens in the west of Ireland declined from 2018-2022, while depressive tendencies increased.
• Personal health behaviours (e.g., sleep, physical activity) and social supports (e.g., school safety, parental support, friend support) are associated with lower self-harm and better mental health outcomes. 
• Approximately 32% of adolescents (i.e., 4th year secondary students) reported having self-harmed at some point in their lifetime. Compared to boys, girls and non-binary teens were more likely to self-harm, and experience poorer mental health outcomes. The significance and strength of protective effects fluctuates depending on one’s history of adversity.
• Irish adolescents, and those from two-parent households, reported better mental health outcomes than adolescents from other family structures or cultural backgrounds. 

Risk and adversity

• Adversity is a key risk factor for self-harm and poor mental health outcomes among young people.
• A large percentage of adolescents experienced adversity across home and/or community (e.g., peer, school) settings.
• The social context (e.g., at home or at school) in which adolescents experience adversity moderates their risk of experiencing poor mental health outcomes or engaging in self-harm behaviours.
• Compared to adolescents who do not experience adversity, those who experience adversity in the parental context are approximately 3 times more likely to self-harm.
• Compared to adolescents who do not experience adversity, those who experience adversity in the peer context are approximately 6 times more likely to self-harm. 
• Compared to adolescents who do not experience adversity, those who experience adversity across multiple contexts (e.g., home, school and peer contexts) are approximately 30 times more likely to self-harm.
• Young people who experience adversity across multiple contexts showed the highest levels of depressive tendencies and the lowest levels of wellbeing and mental health.
• Experiencing adversity (in any context) increases youth’s risk of self-harm and poor mental health – but those navigating adversity across multiple contexts (peer, school, & home) are most at risk. 

Supports (What Helps?)

• Personal health behaviours (e.g., sleep, physical activity) and social supports (e.g., school safety, parental support, friend support) are associated with lower self-harm and better mental health outcomes. 
• The significance and strength of protective effects fluctuates depending on one’s history of adversity.