BRIEF FAMILY INTERVENTION IN ADOLESCENTS WHO DELIBERATELY SELF-HARM

Attempted suicide among children and adolescents is an important, and possibly increasing, public health problem(1,2). Referrals to hospital s because of self-poisoning remain at a high level in this age group; it is the commonest cause of admissions in young women(1). There is a strong association with other psychosocial disorders such as depressio n(3,4), and the repetition rate is about 10%. The health significance of attempted suicide among the young is further underlined by the link with completed suicide. The risk of suicide following parasuicide in adolescents, while probably lower than that of adults, is still consid erable-probably of the order of 0.1%-0.5% over ten years(6,7). Around one-third of adolescents who kill themselves have a history of previou s attempts. Suicide is now the second most common cause of death among young people aged 15-24 years in England and Wales(9). Despite the pu blic health importance of attempted suicide in children and adolescent s, and the heavy demands that these cases put on medical and mental he alth services, there has been little consensus about what after-care i s needed for those patients who do not require psychiatric hospital ad mission. There are no UK controlled studies of the treatment of these patients. Such studies are much needed not only because of the dangers associated with the suicidal act itself, but also because attempted s uicide is often a marker of severe social, interpersonal, or psychiatr ic difficulties such as depression and behavioural disorders. These co ncurrent problems frequently persist(5), and poor social adjustment an d mood disorder are strong risk factors for another attempt(10).