Irish Youth Mental Health: Self-Harm Rises Post-COVID-19 | Healio

Rates of repetitive self-harm among young people have increased since the start of the COVID-19 pandemic, even as overall mental health and suicidal ideation appear to have returned to pre-pandemic levels, according to a study published in Social Psychiatry & Psychiatric Epidemiology. The findings, based on data from over 21,000 adolescents in Ireland, highlight the complex and uneven impact of the pandemic on youth mental health, and underscore the particular vulnerabilities faced by transgender and gender-diverse individuals and those who leave school early.

A Complex Picture of Adolescent Distress

The study, led by Niamh Dooley, MSc, PhD, postdoctoral research fellow at the Social, Genetic and Developmental Psychiatry Centre, King’s College London, analyzed data collected between 2018 and 2023 as part of the Planet Youth surveys in Ireland. Researchers examined rates of poor mental health, repetitive self-harm (defined as self-harming five or more times in a lifetime), and suicide attempts among 15- to 19-year-old secondary school students, as well as a comparison group of adolescents who had left school early.

the data revealed that 19.6% of secondary school students reported poor mental health, 12.1% reported repetitive self-harm, and 8.4% reported a suicide attempt. While rates of poor mental health and suicide attempts had peaked during the pandemic, they had largely returned to pre-pandemic levels by 2023. However, rates of repetitive self-harm continued to climb, increasing from 9.7% during the pandemic to 11.1% two years later – a statistically significant rise.

Disparities in Risk

The study identified several groups at particularly elevated risk. Transgender and gender-diverse adolescents experienced significantly higher odds of all three outcomes – poor mental health (7.41 times higher), repetitive self-harm (12.81 times higher), and suicide attempts (5.38 times higher) – compared to their male peers. Almost a quarter of transgender and gender-diverse individuals reported a suicide attempt, and nearly half had experienced repetitive self-harm.

Adolescents who left school early also faced increased risks, with odds ratios of 1.6 for poor mental health, 1.94 for repetitive self-harm, and 2.87 for a suicide attempt. Among this group, over a quarter reported poor mental health, and nearly 19% had attempted suicide. Family structure also played a role, with adolescents from single-parent households or other non-traditional family arrangements exhibiting higher rates of distress.

Understanding the Trends

Dooley explained that the study aimed to provide an updated national estimate of psychological distress among adolescents in Ireland, given the significant changes in the teenage environment since the last large-scale study in 2018-2019. She highlighted the disruptions caused by the COVID-19 pandemic, as well as the increasing prevalence of smartphone leverage, as potential contributing factors.

The researchers observed that rates of poor mental health and suicide attempts peaked during the pandemic and then decreased as restrictions eased. However, the continued increase in repetitive self-harm, particularly among girls, is a concerning trend. Dooley noted that this rise aligns with data from the National Self-Harm Registry of Ireland, which captures hospital presentations of self-harm.

What the Data Doesn’t Tell Us

It’s important to note the study’s limitations. The data is observational, meaning it cannot prove cause-and-effect relationships. While the study identifies associations between certain factors and mental health outcomes, it cannot determine whether these factors directly cause distress or are simply correlated with it. The study also relied on self-reported data, which may be subject to recall bias or social desirability bias. The sample may not be fully representative of all Irish adolescents, limiting the generalizability of the findings.

The Role of Social Media and Cultural Factors

Experts suggest that the rise in self-harm may be linked to increased exposure to self-harm-related content on social media platforms. Some researchers theorize that the normalization or even glorification of self-harm online may contribute to its spread among vulnerable adolescents. The study authors plan to further investigate this potential link in future research.

Implications for Support and Intervention

The findings underscore the need for comprehensive and targeted mental health support for adolescents, particularly those at higher risk. Dooley and colleagues call for universal and early preventive interventions for suicide attempts, as well as tailored interventions for transgender and gender-diverse youth and those who leave school early. They emphasize the importance of improving access to mental health services in schools, primary care settings, and specialized mental health facilities.

Paul Nestadt, MD, Associate Professor of Psychiatry and Behavioral Sciences at Johns Hopkins Medicine, noted that the Irish findings are consistent with trends observed in the United States. He highlighted the importance of sustained surveillance using consistent measures to track mental health trends and identify populations in need of support. He also cautioned against assuming a uniform post-pandemic trajectory for youth mental health, emphasizing that improvements may not be shared equally across all groups.

Next Steps: Ongoing Surveillance and Targeted Research

Researchers are continuing to monitor mental health trends among adolescents and explore the factors driving these trends. Future research will focus on understanding the role of social media, identifying effective interventions, and addressing the unique needs of vulnerable populations. Ongoing collaboration between researchers, clinicians, and policymakers is essential to ensure that adolescents receive the support they need to thrive.