Ashley Smith

Ashley Smith died in custody after repeated episodes of self-harm, a coroner said. There's been an increasing trend among youth in the number of hospitalizations for intentional self-harm in the past five years in Canada. (The Canadian Press)

Self-harm among youth in Canada is an increasing problem, according to a new report on intentional injuries such as cutting and poisoning.

Tuesday’s report from the Canadian Institute for Health Information focuses on children and youth who are hospitalized for self-harm or assault.

"In 2013-2014, there were nearly 2,500 hospitalizations among youth age 10 to 17 due to intentional self-harm. This equates to one in four injury hospitalizations for youth in this age group," the institute said.

Hospitalizations among youth for intentional self-harm increased from 1,324 in 2009-10 to 2,456 in 2013-14.

For girls aged 10 to 17, intentional self-harm made up 45 per cent of injury hospitalizations last year.

Other types of self-harm include burning, hitting one's head against the wall or punching walls, said Dr. Kathleen Pajer, chief of psychiatry at the Children’s Hospital of Eastern Ontario in Ottawa.

"For the most part, cutting is the most common, and it's particularly most common in girls," Pajer said.

Just as teens may experiment with drinking or drugs during adolescence, some turn to cutting or hurting themselves as a maladaptive way to cope with stress. Some become snared in compulsive behaviour, as pain becomes a reward.

Pajer said parents shouldn’t panic if they see signs of self-harm, but they should try to determine whether the young person is doing it to relieve stress or as a step toward suicide. In the latter case, she recommends seeing a mental health professional.

If it’s stress related, the key is to communicate with a child and teach him or her better ways to reduce stress response, such as going for a walk. Talking about triggers and other ways to handle the situation also helps, she suggested.

Pajer pointed to three potential reasons why self-harm may be on the rise among youth in North America:

  • Stressed families where children need not only support but also structure that busy parents may not be adequately providing. Eating dinner together at least once a week and doing activities together can help give them a home base away from the trials of daily life.
  • Lack of escape from peers who bully and criticize constantly via social media.
  • "Helicopter or bulldozer parents" who have the best of intentions to protect their children from stress by rushing in to rescue them, but remove the opportunity for children to learn to cope with negative emotions like sadness, fear and anger when they’re aged four to six.

Gayle has been a counsellor with Kids Help Phone for 15 years (the counsellors go by first names only). Regarding self-harm calls, she said, about 310 calls a month are from girls and about 35 from boys. The reason for the gender split is unclear.

"It's something that's difficult to stop, so oftentimes Kids Help Phone can be a resource in those moments when they're trying not to self-harm. They can call and talk with a counsellor."

Self-harm by poisoning

In the report, the most frequently used method of self-harm among youth was purposely self-inflicted poisoning, including the use of narcotics, prescription medication, illegal drugs, chemical solvents and alcohol.

Last year, poisoning made up 88 per cent (1,798 or 2,037) of intentional self-harm hospitalizations among girls and 82 per cent (342 of 419) among boys aged 10 to 17, CIHI said.

About eight per cent or 173 girls hospitalized for intentional self-harm used a sharp object. Among boys, hanging or strangulation or suffocation and use of a sharp object each accounted for seven per cent of intentional self-harm hospitalizations.

Intentional assault accounted for nearly six per cent of hospitalizations for injury among those aged 14 to 17.

Over the past five years, the rate of hospitalizations for intentional assaults in girls ranged between five and eight per 100,000. The rate for boys decreased from 17 to 12 per 100,000, the institute reported.

The report was based on data from hospitals across Canada except Quebec.

SELF CUTTING AMONG GIRLS ON THE RISE