Hypothesizing Teen Anguish

"What we found was that yes, incidents of self-harm are increasing, and so are emergency department visits with mental health concerns."
"But I don't think any of the study team members expected such a dramatic rise from 2009 to 2017."
"Engagement with social media could lead to increased rates of self-harm, at least for vulnerable adolescents. This could happen in several ways: by normalizing self-harm, by triggering it, by getting teens to emulate self-harming peers, or by exposing youths to cuber bullying."
"We have hundreds of kids coming to Ontario emergency departments with these problems. The rate is going up every year. The rate is not slowing down."
"But the number of child psychiatrists at CHEO [Children's Hospital of Eastern Ontario, Ottawa] and child psychologists hasn't changed over that period. The number of emergency department personnel hasn't changed. That is really a problem."
"Efforts should be made to increase the supply of and access to evidence-based treatments for adolescents who self-harm or have mental health problems."
"Where possible, it's important to deliver these services to youth before they need to come to an emergency department."
Dr. William Gardner, senior scientist, CHEO Research Institute

CHEO emergency entrance. Wayne Cuddington / Postmedia

The trend toward teenagers turning to self-harm as an expression of their mental health needs being unanswered by health services represents a challenge to any society. Obviously, understanding the motivation or the pathology behind this trend of teens self-harming should be recognized as one of urgent need, both for the medical community and society at large to involve themselves in, since the cost to young peoples' mental health is so grievous and the loss to society of well-adjusted youth is increasing should mark this as a health emergency.

Research, led by Dr. William Gardner and published in the Canadian Journal of Psychiatry, points out that self-harming teen episodes have over-doubled between 2009 and 2017. What, however, is the driver? And until that is understood and measures taken to ameliorate the situation, it is more than obvious that the condition will continue and continue to accelerate. Teens reacting to unidentified stressors have been cutting or poisoning themselves and they are recognized as being at risk for repeated self-harm, and possibly suicide attempts.

There are hints of the increase in self-harm being coincidental in timing with the iPhone's introduction, leading to the ubiquitous use of smartphones in society in general, and among young people in particular. Canada saw iPhones being sold from the summer of 2008 onward and the suspicion among many is that this marked the beginning of increased self-harm among teens. The increased use of iPhones appears to have matched the increase in teens self-harming, according to the research hypothesis.

"Having all these phones in your pocket could be very difficult" for teens who are self-conscious about their social status or appearance to begin with, making them more vulnerable to facing social rejection or being emotionally bullied on-line. The other side of the equation, suggested Dr. Gardner, was that some emotionally unstable youths could benefit through social media, providing them with a venue away from social isolation, encouraging them to look elsewhere for validation, or even realize that they could benefit from health treatment.

The research was based on data retrieved from emergency departments province-wide, between 2003 and 2017, relying on data revealing a trend seen at hospitals and in communities increasingly in recent years.  Rates of youth emergency visits for self-harm happened to decrease by 32 percent between 2003 and 2009, and then swerved dramatically upward by 133 percent between 2009 and 2017. Mental health visits to hospital emergency rooms increased by 78 percent between 2009 and 2017 for all youths, while those linked to self-harm and mental health visits were higher for females, increasing more steadily than for males.

The findings, according to Dr. Gardner, a professor of epidemiology at University of Ottawa, and senior research chair for child and adolescent psychiatry, raise concerns relating to treatment for adolescents who present at emergency departments with mental health issues, where those departments are not equipped to deal with the needs of the teens due to a shortage of appropriate medical personnel. A shortage echoed by child and youth mental health workers province-wide.

As far as the researchers are concerned, emergency departments which represent the first contact in mental health issues for families do not present as an ideal setting for adolescents in crisis, requiring mental health services. Mental health followup through community-sourced medical care where the needs of self-harming teens are the focus remain the most effective source of help. Such followups have been identified with a reduced chance of repeat self-harm by teens, speaking to the success of such community health groups whose critical shortage disadvantages the growing numbers of teens in need.