Monday 27 August 2012

Self-Injury - Series Introduction

This is the first in a series of articles I will be presenting here about Non-Suicidal Self-Injury, also known as self-harm, [or by some antiquated and misguided clinicians as “self-mutilation”].  The series will run throughout September and address many aspects of self-injury from who does it and how, what purpose it serves, what biological factors are involved, what treatment options have seen the greatest success, and what those who self-injure want you to know.  I have named this series after the psychoeducational presentation I created titled:

The definition of self-injury is;

“… the commission of deliberate harm to one’s own body. The injury is done to oneself, without the aid of another person, and the injury is severe enough for tissue damage (such as scarring) to result. Acts that are committed with conscious suicidal intent or are associated with sexual arousal are excluded.”
(Winchel  & Stanley, 1991)

Self-Injury is one of the most misunderstood, mythologized, and ignored mental health issues we face.  It is a topic I became passionate about while working with adolescents who self-injure and through friendships I made in the worldwide self-injury peer support community.  I can state with confidence that I have learned more about self-injury through those who do it than I ever have reading a textbook or in any post secondary course.

I suppose the first question is; “Is this a large enough problem to even bother with?”  The short answer is “Yes.”  The statistics gathered throughout North America and Europe reveal the practice of self-injury is more widespread and more complex than most people realize.

Research conducted by Dr. Mary K. Nixon and her team at the University of Victoria (Nixon, Jansson, Cloutier, 2005) indicated the following results that have been corroborated in various other studies throughout North America;

  • 16.9% of adolescents between the ages of 12 and 18 self-injured for an average of 21 months
  • 75.8% were female
  • Average age of onset was 15.3 years
  • 58% stopped self-injuring during adolescence
  • 42% continued to self-injure into adulthood
  • 83.1% stated they had not used self-injury to attempt suicide

Another more recent longitudinal study (Hawton, Zahl, Weatherall, 2011) conducted in the United Kingdom that tracked 11,583 patients who presented to hospital after deliberate self-injury between 1978 and 1997 revealed the following troubling statistics on completed suicides for people who self-injure long term;

  • Patients were 66 times more likely to complete suicide than the general population one year after onset (0.7%)
  • 5 years after onset - 160 times more likely (1.7%)
  • 10 years after onset - 226 times more likely (2.4%)
  • 15 years after onset - 283 times more likely (3.0%)

To put these numbers into a local perspective, lets look at school populations in the area where my practice is located: The Okanagan Valley in British Columbia has three school districts; Okanagan/Skaha, Kelowna, and Vernon.  Applying the statistics gathered in the above study to enrollment numbers for the 2011-2012 school year;

Vernon School District 22 had 3907 students between the ages of 12-18 years enrolled.  Of those;
  • 660 will self-injure for an average of 21 months
  • 277 will continue into adulthood
  • 8 will complete suicide within 15 years of the onset of self-injury

Okanagan/Skaha School District 67 had 4025 students between the ages of 12-18 years enrolled.  Of those;
  • 680 will self-injure for an average of 21 months
  • 286 will continue into adulthood
  • 8 will complete suicide within 15 years of the onset of self-injury

Kelowna School District 23 had 9426 students between the ages of 12-18 years enrolled.  Of those;
  • 1593 will self-injure for an average of 21 months
  • 669 will continue into adulthood
  • 20 will complete suicide within 15 years of the onset of self-injury

Looking at these numbers is tragic when – aside from the suicide risk - you also take into account the years of pain and suffering these individuals will endure.  And never doubt for a moment that those who self-injure for a prolonged period of time suffer torment as they enter into a cycle of self-loathing/shame, unbearable tension, overwhelming emotional distress, self-injury, and relief.  Relief that once again leads to self-loathing or shame and begins the cycle once more.

Aaron D. McClelland, RPCc –


  1. Interesting research. I was always thinking about statistic for self-harm. I see that young people are most affected with it.

  2. Excellent article. I reposted, obviously giving you credit, a large portion of it on my website

  3. You have done a great job on this article. It’s very readable and highly intelligent. You have even managed to make it understandable and easy to read. You have some real writing talent. Thank you.

  4. I appreciate the thoroughness of the research here. Additionally, the analysis at the very end.