SELF-HARM may be far more common than previously thought, according to new research suggesting 200,000 Australians may have inflicted deliberate damage to themselves in the previous month.
Moreover, a conservative interpretation of the findings suggests hospitalisations because of self-harm cost the Australian health system $5 million to $10m a month.
“It’s more common than we expected and we were rather shocked by the prevalence in the last month [before the survey],” says lead author Graham Martin, director of child and adolescent psychiatry at the University of Queensland.
The research — based on the first representative sample of households to explore the extent of self-harm — found 1.1 per cent of more than 12,000 Australians questioned said they had harmed themselves in the preceding four weeks.
Just more than 8 per cent said they had harmed themselves at some point in their lives.
And far from being a problem unique to troubled young girls, the findings suggest the problem can begin as late as middle age or even older, and that almost as many men as women are affected.
The results, reported in this week’s Medical Journal of Australia, indicate that although self-harm peaks between the ages of 15 and 24 for females and 10 and 19 for males, one man began exhibiting the behaviour at 44, while one woman was 60.
According to Martin, previous thinking, based partly on a US survey, held self-harm to be largely a problem among young women who were “hysterical or doing it to attract attention”.
“Our clinical experience didn’t fit with that,” he says.
“We were also surprised to find that the number of males affected was almost equal to the number of females.
“If you say ‘Have you cut yourself or burned yourself?’, not many men do that, but you ask a more open-ended question, such as ‘Have you ever hurt yourself deliberately?’, it turns out a lot of men do it, just in different ways.”
Men tended to hit walls, bang their heads or provoke others into harming them, he says, because the endorphin rush proved to be one way of coping with the boiling emotions they lacked the skills to deal with otherwise.
Self-harm as a coping mechanism was evident in “large numbers of people in their 40s and 50s”.
Martin claims the implications are significant because there was a clear link between persistent self-harm and suicidal behaviour.
But attitudes from doctors were often less than helpful because of an apparent belief among some doctors and nurses that patients who harmed themselves deserved less sympathy.
“When these people go to the emergency department they are often treated very badly . . . a dozen people have come to me in the past couple of years to say they were sewn up without anaesthetic,” Martin says.
“The reasons given [by the doctor or nurse] were things like ‘I hear you like pain, I can assist with that.’ That’s just bizarre.”
Martin claims the findings show that self-harm is as big a problem as post-traumatic stress and obsessive compulsive disorder.
He concludes: “It’s a fairly high-frequency disorder by comparison and it’s not getting any attention whatsoever”.