title: Risk factors for self-harm in children and adolescents admitted to a mental health inpatient unit.
abstract: OBJECTIVE
  The aim of this study was to identify risk factors for self-harm for children and adolescents in a mental health inpatient unit.
  
  
  METHODS
  A retrospective file audit of patient files over three years (2006-2009) was conducted to determine risk factors associated with self-harm in children and adolescents admitted to a mental health unit. A checklist of potential factors was based on risk factors found in a review of the literature including demographic information, diagnosis, home situation, environmental stressors, childhood trauma and previous mental health care. The study compared those who self-harmed with a control group who did not self-harm.
  
  
  RESULTS
  There were 150 patients who self-harmed (mean age 14 years) and 56 patients who did not self-harm with a mean age of 13 years. Several factors were identified that increased the likelihood of self-harm, including a diagnosis of depression, female gender, increasing age, being Australian-born, living with a step parent, not having received previous mental health care, having a history of trauma, and having other stressors including problems within the family.
  
  
  CONCLUSIONS
  While increasing age, female gender, a history of trauma and a diagnosis of depression are well known as risk factors for self-harm, this study confirms that family factors, in particular living with a step parent, significantly add to the risk. Child and adolescent services should be aware of the increased risk of self-harm in young people with mental health problems who live in blended families. Treatment approaches need to involve parents as well as the child or young person.
authors.affiliation: Walker Unit, Concord Centre for Mental Health, Hospital Road, Concord West, New South Wales 2138, Australia.
authors.forename: Liselotte
authors.initials: L
authors.lastname: de Kloet
authors.forename: Jean
authors.initials: J
authors.lastname: Starling
authors.forename: Cassandra
authors.initials: C
authors.lastname: Hainsworth
authors.forename: Ellen
authors.initials: E
authors.lastname: Berntsen
authors.forename: Lucy
authors.initials: L
authors.lastname: Chapman
authors.forename: Karen
authors.initials: K
authors.lastname: Hancock
mesh_terms: D000293:Adolescent; D002648:Child; D003863:Depression / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D012737:Sex Factors; D059020:Suicidal Ideation