Experts urge policy action on societal drivers and health services’ response in a new Lancet Commission

Assembled from worldwide experts, including Professor Amy Chandler from the School of Health in Social Science at the University of Edinburgh, the Commission spent four years researching and compiling research, which paints a stark picture of the current state of self-harm and the urgent need for policy intervention.  

Lived experience perspectives formed a vital focus of the Commission, as part of five key pillars shaped by groups of experts. Professor Amy Chandler was asked by the Commission Chairs to lead on the lived experience perspectives pillar because of her academic and lived experience expertise in self-harm. As pillar lead, she brought together a team of writers from Australia, India, the United Kingdom and Canada who were all experts with lived and living experiences of self-harm. Through the work they did, the lived experience pillar were able to provide a vital perspective and influence pivotal aspects of the framework of the Commission.  

Self-harm is when someone hurts themselves on purpose, regardless of the reasons for doing this. Often, shame and stigma stop people from seeking help. Self-harming behaviour increases the risk of death by suicide, and it is a common cause of disability in young people. Currently, people attending health services only represent the tip of the iceberg; the proportion of teenagers self-harming has increased over the past 20 years—this is particularly so for young women and girls. 

The actual number of annual self-harm events is unknown; current levels are likely underestimated. The Commission highlights that at least 14 million episodes of self-harm occur each year, with the greatest burden felt in low- and middle-income countries (LMICs) and higher incidence among young people. This figure is likely an underestimate as people who self-harm often do not present to health services, there are few routine surveillance systems, and self-harm with suicidal intent is still a criminal offense in some countries. Attitudes lacking empathy, including in healthcare settings, can compound stigma and keep people from seeking help.