Young men are increasingly turning to self-harm in response to abuse and confusion about their role in society, doctors have said.
By Laura Smith-Spark
BBC News Online
The warning comes as a new set of guidelines is issued urging doctors and nurses to treat self-harmers with the same respect as any other patient.
Deliberate cuts on the body are a common form of self-harm
Triggers for men and women can include abuse in childhood, domestic violence or the breakdown of a relationship.
Health workers who try to stop people self-harming without understanding the complex causes may make things worse, experts said.
Dr Tim Kendall, a consultant psychiatrist and co-director of the National Collaborating Centre for Mental Health (NCCMH), which drew up the new guidelines, said the problem of self-harm was "substantial and growing".
Self-harm is the third largest cause of death in 10- to 13-year-olds, Dr Kendall said, and is also an increasing phenomenon among young men aged 20 to 35.
"There's a rise amongst men probably in part because of problems about role confusion," he said.
"Over the last 20 years it's become less and less clear what's valuable about being a bloke.
"Also we've gone through long periods where it's been quite difficult for young men to get jobs, so there's a big issue in that sense.
"The culture for blokes means they are much less likely to discuss the sorts of things like emotional problems - they are more reticent than women."
Men are much less likely than women to discuss emotional problems
Dr Kendall said self-harm often functioned as a coping mechanism for people who had suffered abuse.
"People who self-harm frequently often had very difficult childhoods and also were abused physically, mentally or sexually," he said.
"It also occurs where people suffer domestic violence, bad life events like the break-up of a relationship and violence, or in people who are depressed or people who have very heavy drinking problems."
Methods of self-harm can range from overdosing on over-the-counter drugs and swallowing chemicals like bleach to cutting, gouging or scratching the skin.
Richard Pacitti, chief executive of mental health charity Mind in Croydon and an adviser on the new guidelines, said health workers often felt frustrated by their inability to help self-harmers.
"They don't really understand what self-harm is about. They seem to feel that if they are unsympathetic to people, it will discourage them from self-harming again," he said.
"The problem is that the evidence shows it's counterproductive and actually likely to make people feel worse and more likely to self-harm."
He said treatment was not a simple matter of keeping people away from knives or over-the-counter drugs because of the complex causes underlying the behaviour.
"We know from research that self-harm is used as a coping mechanism for people, many of whom have had fairly horrendous things happen to them," he said.
"There is a build-up of these unbearable feelings and they have found self-harm is their way of coping with these particular feelings."
Mr Pacitti said self-harm could have a "positive value" because it gave relief to people who otherwise may have attempted suicide.
He recommended training health workers to see their role as helping to minimise self-harm rather than stop it altogether, with more emphasis given to directing patients to therapy and self-help groups.
"Self-harm isn't a disease or illness, it's an aspect of some people's behaviour," he said.
"If you take away someone's coping mechanism without giving them another one, it's not going to work."