Back to twenty five years ago when I was a junior surgeon in China, every evening and night shifts I had some suture work to do on the wrists of the self-harm teen girls, with their relatives or boyfriend standing aside watching. In China by then, there was no drug abusing, no internet social media, but it was very common in the teen girls. I don’t have the prevalence back then, but our hospital was the central hospital in a city of six million people. Most of the self-harms were not lethal, and some were indeed not intentionally lethal, but there were some heart-breaking lethal ones. At that time, we attributed this to the soap drama on TV that frequently contains the wrist cutting scene.
What about now?
It is 2017 now, the incidence of self-harm in teen girls rises sharply with the increase of 67% compared to 2013. The situation is certainly more complicated than 25 years ago, even though the underlying motivation can both be “tension-discharge behavior”. According to the data in this article, the soaring number is worldwide. It is being attributed to the social media and anxiety, stress, depression conditions in girls. In boys the causes are conduct disorder, attention deficit hyperactivity disorder and schizophrenia spectrum disorder. And unlike girls, boys commonly uses alcohol-drinking rather than wrist-cutting.
The self-harm is the major risk factor for subsequent suicide that is the #2 cause of death only second to accidents. Physicians have the responsibility to take care of these teenagers’ risky behaviors. Epidemiology data has shown the inherent social factors. Social media can be the quick way of spreading harmful information, and also the cause of recent sharp increase worldwide. Perhaps in psychiatry, the social factor and medical factor can never be separated from each other, and both school counselor and doctors should be actively involved in the counseling.