Preventing self-harm and suicide in adolescents
19 February 2016
Self-harm is relatively common among adolescents. It causes distress to the young people concerned, as well as to their family and friends, and is associated with poor mental health and future substance abuse. Many young people also experience suicidal thoughts.
Dr Becky Mars, a research associate in the School of Social and Community Medicine, has been developing proposals for an e-health intervention aimed at reducing self-harm, and for a research project that could help identify those adolescents most at risk of attempting suicide.
Dr Mars’ research focuses on self-harm and suicidal behaviour in young people. Her work with participants of the University’s renowned birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC) – also known as Children of the 90s – suggests that almost one in five adolescents will have self-harmed by the time they reach 16. Despite this, most young people who self-harm do not seek help from medical services.
Dr Mars used her Elizabeth Blackwell Institute (EBI) Early Career Fellowship award to fine-tune a proposal for a post-doctoral fellowship with the National Institute for Health Research (NIHR) for an e-health intervention for young people at risk of self-harm. The idea would be to provide information, advice and support to vulnerable young people online or via a smartphone app. Digital solutions such as these have the potential to engage a wide audience of young people, especially those who might be reluctant to seek help through more traditional channels.
As part of the proposal development work, Dr Mars conducted a scoping review of the existing literature on e-health interventions for self-harm and suicide, and carried out a focus group with adolescents from local schools (aged 16-17 years). The proposal was submitted to NIHR last year.
Theoretically driven research
A second fellowship proposal, submitted to the American Foundation for Suicide Prevention (AFSP), aims to use existing data from the ALSPAC birth cohort to examine why some young people act on suicidal thoughts whereas others do not. The fellowship involves collaborations with researchers in the UK and Canada and will test hypothesis relating to recently developed theories of suicidal behaviour. The hope is that this work could help to identify young people who are at high risk of attempting suicide, and help to develop effective treatments.
The EBI Fellowship enabled Dr Mars to develop the research idea, review the literature and develop links with potential collaborators. The proposal was submitted to AFSP at the end of 2014 and was awarded in 2015. Dr Mars began working on the fellowship in January this year.
As part of her AFSP fellowship, Dr Mars plans to publish at least four papers, and will disseminate her findings at international conferences. Dr Mars also plans to collaborate with colleagues in Bristol to develop a number of new grant applications, to extend her current work, and collect new self-harm data from ALSPAC participants.
Particularly useful have been the relationships that Dr Mars has forged with colleagues both across and beyond the University. For the NIHR application, she collaborated with Dr David Coyle (Department of Computer Science) and Professor Marcus Munafo (Experimental Psychology), as well as colleagues from the Universities of Exeter and Bath.
She also developed links with relevant voluntary and charitable organisations, including the Samaritans, the local self-harm Health Integration Team (STITCH), and the Bristol-based group Off the Record, which provides confidential mental health support and information to young people.
Work on the AFSP fellowship involved collaboration with colleagues at Kings College London, and the Universities of Glasgow, British Colombia and Cambridge. These collaborations have led to a planned cross-cohort comparison between ALSPAC and the Cambridge-based ROOTS cohort.
Improving Care in Self-Harm Health Integration Team, Bristol Health Partners
Please visit the EBI Website to learn more about the funding available from the Elizabeth Blackwell Institute, including Early Career Fellowships.