Investigating the iceberg model of self-harm and suicide in children, adolescents and young adults: a multi-methods study of predictors of onset, escalation and premature mortality

Rates of self-harm among children, adolescents and young adults in Ireland have increased sharply in the past decade and rates of youth suicide remain high. Self-harm and suicide have been described as an "iceberg", with the rare event of suicide as the tip of the iceberg. Beneath this are higher rates of self-harm resulting in hospital attendance, some with suicidal intent. At the base of the iceberg is the very common but often hidden phenomenon of self-harm which does not come to the attention of health services. Further research is needed to identify what causes some young people to harm themselves, and what leads to repeated, increasingly medically serious self-harm and ultimately suicide in a small number of young people. Furthermore, very little is known about the experiences of engagement with health services among young people have harmed themselves. This research programme will address these gaps through three inter-related work packages. Work package 1 will involve a follow up of all young people nationally who have presented to hospital following self-harm over a 5-year period in order to calculate their risk of subsequent suicide. Work package 2 will involve interviews with young people who have harmed themselves, coupled with clinical data on treatment and care to identify predictors of increasingly serious self-harm. In work package 3 I will use data from two large studies of young people from the general population to examine factors which precede the onset of self-harm in adolescents. The results of this research programme will lead to better understanding of what interventions and treatments may be successful at preventing self-harm and suicide in young people.

Award Date: 27 September 2018
Award Value: €216,106.00
Principal Investigator: Professor Elaine Mc Mahon
Host Institution: University College Cork
Scheme: Applying Research into Policy & Practice Postdoctoral Fellowships