Protecting young people from self-harm when a parent has mental health difficulties

Understanding what helps young people do well despite adversity is central to their mental health care. Estimates suggest that around 24% of adolescents have self-harmed in the past 12 months and over 7% have made at least one suicide attempt.

Parental mental health difficulties and suicidal behaviour are strong risk factors for self-harm among young people. Evidence from the Avon Longitudinal Study of Parents and Children (ALSPAC) shows that young adults whose mothers reported thoughts of self-harm were more likely to experience depression and engage in self-harm themselves.

The traditional risk assessment tools used to evaluate the risk of self-harm and suicide have limited value and perform poorly in real-world clinical settings. This has led to the development of the Health Outcomes from Positive Experiences (HOPE) framework.

HOPE is an approach that focuses on how positive childhood experiences, supportive relationships and existing strengths help children grow into healthy, resilient adults. It complements efforts to prevent childhood adversity by highlighting the experiences that can actively protect children from harm and support healthy development.

Project aims

The aim of this project is to:

• Examine the potential relationship between parental mental health difficulties and self-harming thoughts and behaviours experienced by adolescents
• Explore whether protective factors may moderate this relationship

What we have done so far

We followed up 4,340 children from the Avon Longitudinal Study of Parents and Children (ALSPAC) in relation to reports of parental mental health difficulties and self-harm thoughts or behaviours among adolescents.

We looked at protective factors aligning with the HOPE framework to understand whether they moderate the relationship between parental mental health difficulties and self-harm thoughts and behaviours in young people.

We found that maternal and combined parental mental health difficulties, but not paternal mental health difficulties, were associated with an increased likelihood of adolescent self-harm.

Higher levels of protective factors were associated with a smaller likelihood of self-harm both in adolescents who had and those who hadn’t been exposed to poor parental mental health.

How confident young people felt, how well they communicated with others, and how much control they felt they had over their lives had an impact on their likelihood of experiencing self-harm thoughts and behaviours.

What we hope to achieve

We will work with young people to evaluate our findings.

We hope our findings will inform the future development of a protective factor framework and contribute to the creation of training materials for healthcare professionals.