Rates of youth self-harm have increased significantly in recent years, with self-harm the strongest risk factor for subsequent suicide. Research during and since the COVID pandemic has highlighted the disproportionate impact of the pandemic on young people, and the accelerating impact of social inequalities in youth mental health. Despite evidence of systematic inequalities in the risk of suicidal behaviour, equality issues have neither received the research nor the policy focus required to fully understand and address emerging trends. There is a well-documented need for a more advanced understanding of modifiable risk factors and potential targets for interventions to reduce inequalities.
The proposed research programme will utilise multiple study designs to examine the social determinants of self-harm and suicide in children, adolescents and young adults. Three large-scale national research studies will examine structural and intermediary determinants of suicidal behaviour. In Workpackage 1, a complete national cohort of youth suicide cases will be examined and the impact of structural determinants on suicide risk will be quantified through comparison with national census data. In Workpackage 2, social determinants of suicide attempts and suicidal ideation in the community will be examined in a representative sample of adolescents and young adults. In Workpackage 3, potential causal and mediating pathways from childhood deprivation to self-harm in adolescence and early adulthood will be identified in a national longitudinal cohort. The findings of these studies will advance our understanding of the social determinants of self-harm and suicide, moving beyond a prior focus on psychiatric factors to identify high-risk sub-groups of young people and mechanisms by which self-harm may develop. In Workpackage 4 the findings of the study will be synthesised and policy priorities to reduce inequalities will be identified. The overall aim of the research programme is the generation of actionable knowledge for youth self-harm and suicide prevention.