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. The “iceberg” of suicidal behaviour has been postulated, in which the tip of the iceberg is the highly visible but rare event of suicide, beneath this higher rates of hospital-treated self-harm, and at the base the very common but often hidden phenomenon of self-harm which does not come to the attention of health services. Significant gaps remain in our knowledge of the factors associated with onset and escalation of self-harm in young people. Furthermore, very little is known about the experiences of engagement with health services among young people have harmed themselves. This inter-disciplinary research programme will address these gaps through three inter-related work packages using multiple methods and designs to examine three key stages of the self-harm process; onset of self-harm among adolescents in the community; high-risk hospital-treated self-harm, and long term risk of suicide following self-harm.
Work package 1 is a national cohort study in which I will examine long term risk of suicide and other premature mortality among young people who have presented to hospital following self-harm. Work package 2 is a mixed methods study of engagement with health services among young people with high risk self-harm and associations with subsequent repeated self-harm. In workpackage 3 I will examine risk and protective factors for onset of suicidal behaviour among adolescents in the community in one large nationally representative longitudinal cohort of young people (Growing up in Ireland study) and one international sample (Saving and Empowering young Lives in Europe study). The outcomes of this inter-disciplinary research programme will have an impact on both suicide prevention policy and mental healthcare service delivery.
