Self-harm 'increasingly key characteristic' of detained youths

Young Scots who have been detained for mental health reasons are self-harming at a growing rate, according to a new report.

The Mental Welfare Commission has published a paper analysing the detentions of people aged 16 and 17.

It found that self-harm was a key characteristic – particularly among young women – with reports having risen from 50% of patients in 2014/15 to 66% in 2018/19.

Dr Arun Chopra, medical director of the commission, said: “Mental illness in young people can be short term, or can be the start of a prolonged period of difficulty.

“It can disrupt education, the development of friendships and the transition into adulthood, significantly affecting both the young person and their family or carers. Getting the right help early can make a major difference.

“We conducted this analysis because we knew that detentions of young people were rising, and we wanted to understand better the characteristics and presentations of young people who are so unwell that they need to be treated under the law.

“Our analysis does not attempt to say why the detentions are increasing, but it does give information on these two key issues.

“We now aim to share these findings and hope they might be a helpful contribution for young people, those important to them and the services and clinicians working with them, in considering who might be supported by developing intensive treatment services in the community and alternatives to hospital admissions.”

The number of 16 and 17-year-olds being detained in Scotland under the Mental Health Act has risen from 106 in 2014/15 to 173 in 2018/19, according to the report.

Over the five-year period, 60% of detained patients displayed self-harming behaviours – including suicidality or deliberate self-harm.

Most detentions related to concerns about the patient’s own safety, though boys were more often a risk to themselves and to others compared with girls.

Psychotic symptoms were the most common features (40%), with a higher proportion among boys than girls (54% and 32%, respectively).

Dr Justin Williams, vice-chairman of the child and adolescent faculty at the Royal College of Psychiatrists in Scotland, said: “These are very worrying figures and further evidence that the mental health of our young people is deteriorating at an alarming rate, as we see escalating levels of mental ill-health at all levels.

“Every single one of those cases represents a young person whose life has been thrown into complete turmoil by their mental illness and the levels of risk and distress are incalculable.

“We should be doing everything we can to stop each person’s mental health deteriorating to the point of detention.”