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Aust N Z J Psychiatry. 2011 Sep;45(9):749-55. doi: 10.3109/00048674.2011.595682. Epub 2011 Aug 10.

Risk factors for self-harm in children and adolescents admitted to a mental health inpatient unit.

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Walker Unit, Concord Centre for Mental Health, Hospital Road, Concord West, New South Wales 2138, Australia.



The aim of this study was to identify risk factors for self-harm for children and adolescents in a mental health inpatient unit.


A retrospective file audit of patient files over three years (2006-2009) was conducted to determine risk factors associated with self-harm in children and adolescents admitted to a mental health unit. A checklist of potential factors was based on risk factors found in a review of the literature including demographic information, diagnosis, home situation, environmental stressors, childhood trauma and previous mental health care. The study compared those who self-harmed with a control group who did not self-harm.


There were 150 patients who self-harmed (mean age 14 years) and 56 patients who did not self-harm with a mean age of 13 years. Several factors were identified that increased the likelihood of self-harm, including a diagnosis of depression, female gender, increasing age, being Australian-born, living with a step parent, not having received previous mental health care, having a history of trauma, and having other stressors including problems within the family.


While increasing age, female gender, a history of trauma and a diagnosis of depression are well known as risk factors for self-harm, this study confirms that family factors, in particular living with a step parent, significantly add to the risk. Child and adolescent services should be aware of the increased risk of self-harm in young people with mental health problems who live in blended families. Treatment approaches need to involve parents as well as the child or young person.

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