One in four youth in S'pore have engaged in self-injury without suicidal intent: Study
This behaviour often signals underlying issues, such as overwhelming emotions or distress. PHOTO: ST FILE
One in four youth in S'pore have engaged in self-injury without suicidal intent: Study
SINGAPORE – One in four young people here say they have hurt themselves at least once in their lives, in ways such as cutting or punching themselves.
This was the finding of a recent study that shed new light on the prevalence and patterns of non-suicidal self-injury (NSSI) among young people in Singapore.
NSSI typically includes cutting, burning, hitting or otherwise inflicting physical harm.
The study found that the median age that NSSI behaviour starts was 14, while males had a second peak at around 18 years of age.
Repetitive NSSI, defined as at least five instances of self-harm, was reported by 11.6 per cent of respondents.
Helplines Mental well-being Institute of Mental Health's Mental Health Helpline: 6389-2222 (24 hours)
Samaritans of Singapore: 1-767 (24 hours) / 9151-1767 (24 hours CareText via WhatsApp)
Singapore Association for Mental Health: 1800-283-7019
Silver Ribbon Singapore: 6386-1928
Chat, Centre of Excellence for Youth Mental Health: 6493-6500/1
Women's Helpline (Aware): 1800-777-5555 (weekdays, 10am to 6pm) Counselling Touchline (Counselling): 1800-377-2252
Touch Care Line (for caregivers): 6804-6555
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We Care Community Services: 3165-8017
Clarity Singapore: 6757-7990 Online resources mindline.sg
eC2.sg
tinklefriend.sg
chat.mentalhealth.sg
carey.carecorner.org.sg (for those aged 13 to 25)
limitless.sg/talk (for those aged 12 to 25)
shanyou.org.sg
The most common method of self-injury in the study was cutting, which was prevalent among almost 13.5 per cent of young people. This was followed by severe scratching, punching themselves, and banging their heads against something.
The study, published in March, took data from the National Youth Mental Health Study, which involved 2,600 participants aged 15 to 35. The national study was conducted by the Institute of Mental Health (IMH).
Dr Swapna Verma, chairman of the medical board at IMH, told The Straits Times that NSSI is not a mental disorder but a behaviour that often signals underlying issues.
'Young people may resort to self-harm as a way to cope with overwhelming emotions or distress that they don't have the tools to manage in healthier ways.
'For some, it provides a temporary relief from intense feelings like sadness, anger, anxiety or numbness. Others may use it to communicate distress.'
The study highlighted certain risk factors associated with self-harm.
Females were twice as likely as males to engage in self-injury. IMH senior research officer Sherilyn Chang said that though some studies show NSSI to be more prevalent among females, research on gender differences in NSSI prevalence remains mixed.
'A reason for higher odds in females could be that females tend to experience greater levels of psychological distress, and this in turn is associated with higher odds of NSSI.'
Some studies have reported that females often try to manage their emotions more than males, she said.
'However, this increased attention on regulating emotions can sometimes have the opposite effect, especially if it involves overthinking or dwelling on negative feelings. Over time, the distress is sustained or intensified and may lead to NSSI behaviour.'
Young people aged 15 to 29 and those with lower educational attainment also reported higher odds of self-injury, and those experiencing severe or extremely severe symptoms of depression and anxiety were more likely to engage in the behaviour.
Those who had body image dissatisfaction were twice as likely to engage in NSSI than those who were not.
Ms Chang said: 'It is suggested that individuals with body dissatisfaction develop a disregard for their body and may be indifferent about protecting it, along with an increased tolerance for pain.
'Such indifference and disregard for their body facilitates individuals in engaging in self-injurious behaviours when they face intense emotional distress.'
Although about one in four young people have hurt themselves at some point in their lives, far fewer reported having done so in the past 12 months.
Researchers suggest this may be due to older participants outgrowing the behaviour, developing healthier coping strategies, or receiving professional help over time.
Given that NSSI begins early at the median age of 14 and its overlap with the schooling years, researchers from the study stressed the importance of training school personnel like teachers and counsellors to recognise and appropriately respond to signs of self-harm.
They also called for more preventive programmes to focus on reducing the start of self-injurious behaviours. This could include programmes aimed at enhancing resilience in young people or teaching healthier coping strategies that can help them regulate their emotions.
Currently, mental health education lessons in the Character and Citizenship Education curriculum aim to equip students with knowledge and skills to manage their emotions, differentiate normal stress from distress or mental illnesses, and to seek help when needed.
It is also important to improve awareness and knowledge of the issue on a broader societal level, researchers said, as self-harming behaviour is often associated with shame and stigma, and young people may often choose to keep quiet about it.
Dr Swapna said parents and caregivers may not realise that it is an issue, as teenagers tend to hide their self-harm, often carrying it out in secrecy due to shame or fear of disapproval.
Knowing more about non-suicidal self-injury and the warning signs to look out for, like unexplained cuts or bruises, frequent isolation, or sudden mood changes, can help parents and caregivers respond more appropriately, she added.
'Invalidating the young person's struggles or being judgmental strains the relationship and may be distressing to someone already struggling with self-harm.
'Instead, it is important to create a space where the teen feels safe to talk, to listen without judgment, and to help him or her acquire new skills to process and regulate emotions, and cope with stressors.'
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