To consider this report.
The Committee considered this report from the Director of Public Health that provided analysis of available data to help understand the apparent high rates of self-harm in Somerset. It was explained that the picture was highly complex, with only hospital admissions being easily measurable. Such admissions were typically the result of paracetamol overdoses by young women rather than self-cutting (as self-harm is often discussed).
It was reported that most admissions for overdoses were ‘one-off’, rather than repeated incidents. This implied that an approach based on universal (tier 1), or more specialist (tier 2) services would be more effective than one based on more complex tier 3 and 4 services. It was also noted that the protective and preventative benefits of emotional health and wellbeing should be taken into consideration in all services for children and young people, especially girls between the ages of about 13 and 20.
Members were reminded that Somerset had a ‘red dot’ for self-harm admissions to hospital, meaning that its rate of admissions was much higher than England as a whole. Previously it had been assumed this was a result of effective admission and assessment of self-harm at Somerset hospitals. However over recent years the rates in Somerset had risen still further meaning a rate much higher than the national average.
There was a discussion and in response to a question it was stated that analysis of the figures showed that the majority of self-harm admissions were for overdoses, particularly of paracetamol and other painkillers, and were predominantly taken by young women. Overall such admissions were ‘one-off’, which seemed to indicate that they might be a response to a personal crisis rather than a symptom of longer term mental ill health. It was further explained that evidence suggested that those overdoses were very rarely attempted suicides, and there did not appear to be a clear link between self-poisoning and the bulk of ‘low level’ self-harm, which was predominantly self-cutting.
It was stated that this behaviour suggested that the most effective response would be to strengthen the support available to young people, especially girls, at Tiers 1 and 2 (universal services and those for relatively common and low-level need). This would help to promote their own resilience in the face of the unavoidable difficulties of adolescence; however, evidence suggested that availability of such support was patchy and uncoordinated in Somerset. Rather than being a health problem that needed treatment in the NHS, support can often be provided through schools, although it was noted parents, GPs and other professionals would benefit from more available guidance and services to improve young people’s wellbeing.
In summary the conclusion seemed to be that evidence pointed to the most effective interventions being the overall promotion and support of mental health and emotional wellbeing for all young people, especially girls, rather than providing specialist services. The Chair of the Committee reflected that the mental health and well-being of others was a matter for all, not just the NHS.
The report was accepted and it was requested that a further update be considered at the June meeting.