Background
Early identification, accurate diagnosis and effective treatment of mental health conditions can prevent self-harm and suicide in children and young people. Self-harm is when somebody intentionally damages or injures their body, and is a common way of responding to or expressing overwhelming emotional distress. Hospital admission rates are a useful measure of intentional self-harm, and an indicator of how well we are preventing these mental health crises from occurring.
Self-harm admissions in children and young people
Rates of hospital admission as a result of self-harm in children and young people (aged 10–24) are considerably higher for females than males. Between 2012/13 and 2021/22, the rate for females rose from 508 admissions per 100,000 population to 711 per 100,000 population – an increase of 40% - followed by a sharp decrease to 531 per 100,000 in 2022/23. Between 2012/13 and 2021/22 the inverse effect has been observed for males, as the rate of admissions decreased by 22% from 193 per 100,000 population to 154 per 100,000 population. This decreasing trend has continued in 2022/23 to 116 per 100,000 population – the lowest rate recorded up to date.
This data does not take A&E attendances into account, so the true prevalence of self-harm could be much higher. However, the gender difference in hospitalisation rates do reflect gender differences in self-harm practices as young women aged 16–24 years are more likely to report having self-harmed than young men.
The significant drop in hospital admissions due to self-harm across genders in 2022/23 may be due to the change in NHS England’s reporting methodology, which reclassified Same Day Emergency Care (SDEC) cases, leading to fewer admissions being recorded under the Admitted Patient Care data set. For more details, please see the “About this data” section.
Rates of hospital admission as a result of self-harm in children and young people are considerably higher for children and young people between the age of 15–19 than children aged 10–14 years and young people aged 20–24 years. Between 2011/12 and 2021/22, the rate for the 15–19 years age group increased from 469 per 100,000 population to 642 per 100,000 population, a 37% increase. However, in 2022/23, this rate has fallen to 468 per 100,000 population.
Over the 2011/12 to 2021/22 period, the rate of admissions for the 10–14 years age group also saw an increase, from 124 per 100,000 population to 307 per 100,000 population. In 2022/23, this rate slightly decreased to 251 per 100,000 population.
A decrease in admission rates was recorded for the 20–24 years age group, which fell by 43.5% from 432 per 100,000 population in 2011/12 to 244 per 100,000 population in 2021/22.
Despite these reported drops in hospital admissions, these is an observed decline in mental health of children and young people in these age categories. In 2023, 23% of all 17–19-year-olds were estimated to be experiencing a mental health problem compared with 10% six years earlier. For a younger cohort of individuals aged 11–16 years of age, the figure rose from 13% in 2017 to 23% in 2023 (data not shown).
A possible explanation for the significant drop in hospital admissions due to self-harm for all age groups in 2022/23 is the change in NHS England’s reporting methodology, which reclassified Same Day Emergency Care (SDEC) cases, leading to fewer admissions being recorded under the Admitted Patient Care data set. For more details, please see the “About this data” section.
About this data
The data for this indicator is produced by the Office for Health Improvement and Disparities’ Public Health Analysis.
Chart: What are the trends in hospital admissions as a result of self-harm in children and young people?
Definition:
Directly standardised rate of finished admission episodes for self-harm per 100,000 population aged 10–24 years.
Numerator:
Number of finished admission episodes in children aged between 10 and 24 years where the main recorded cause is intentional self-harm.
Denominator:
Mid-year population estimates: single year of age and sex for local authorities in England and Wales (ages 10–24 years).
Chart: How does the rate of hospital admissions as a result of self-harm in children and young people vary by age group?
Definition:
Crude rate of finished admission episodes for self-harm per 100,000 population.
Numerator:
Number of finished admission episodes in children where the main recorded cause is intentional self-harm. Age groups 10–14 years, 15–19 years, 20–24 years.
Denominator:
Local authority figures: Mid-year population estimates: Single year of age and sex for local authorities in England and Wales; estimated resident population. For more information, please see the Office for Health Improvement and Disparities’ Indicator Definitions and Supporting Information.
Caveat:
In 2023, NHS England mandated a methodological shift requiring Trusts to report Same Day Emergency Care (SDEC) to the Emergency Care Data Set (ECDS) by July 2024. Early adopter sites began this transition in 2021/22, with additional Trusts following in 2022/23 and 2023/24. This change resulted in previously reported admissions under the Admitted Patient Care data set being reclassified under SDEC, thus reducing the number of admissions for certain indicators, including self-harm.