Rising self-injury rates reported among youth

Data published in JAMA Network Open has indicated a significant increase in annual self-injury rates among children and adolescents, highlighting the need for large-scale prevention efforts.¹

Self-injury has been reported in approximately 10% of youth, indicating this event as a major public health concern worldwide. Additionally, self-injury has been linked to future mental health challenges such as anxiety, depression, substance use disorders, and risk of completed suicide.² However, nonsuicidal self-injury is 5-fold to 10-fold more likely than suicide attempts.¹

“Differentiating between trends in suicide and those of self-injury is important so that interventions to address these events focus on the appropriate part of the spectrum of self-destructive behaviors among youth in high-income countries,” wrote investigators.

Assessing self-injury trends

The systematic review and meta-analysis was conducted to evaluate trends in self-injury among pediatric patients. Data published between January 1, 2000, and December 13, 2024, was obtained through systematic searches of the Ovid MEDLINE, PsycArticles, PsycINFO, and Ovid Embase and Embase Classic databases.

Titles and abstracts were screened by 2 independent reviewers, who then performed full text screening with a third reviewer solving discrepancies. Studies were either regional, national registry, or multifacility based and were longitudinal or repeated cross-sectional in design.

Patients were 24 years or younger and study data spanned at least 5 years to assess temporal trends. Self-injury was reported as the primary outcome based on diagnostic codes, while self-reported self-injury was included as a secondary outcome. A population denominator was also required.

Studies without general population measures, measuring only suicidal ideation and not distinguishing suicidal ideation and self-injury or suicide attempt, were excluded. Data were extracted by 2 study authors and included study location, years, sample size, population age, self-injury definitions, type or method of self-injury, even counts, and prevalence.

Trends in self-injury rates

There were 30 studies and 12 literature reports included in the final analysis. Of these, 13 included only patients younger than 18 years while the remainder included patients aged up to 24 years. Settings included emergency department visits, hospitalizations, primary care, and self-reported surveys.

In 2000, which was the first year of data, a mean intercept of 10.2 self-injury visits per 10,000 population was reported. Twenty of the 32 studies reported an upward trend in this rate during the study period regardless of geographic region, with an effect estimate of 3.5% per year. The remaining studied primarily showed null trends.

Increases in self-injury rates were also reported over time when measured through different model assumptions with mixed effects. However, trends did not significantly differ before vs after 2010. Annual rate increases across regions ranged from 2.8% to 4.3%.

Gender differences and self-reported data

Sensitivity analyses indicated an initial mean self-injury rate of 14.1 per 10,000 population and annual relative rate increase of 3.6% among girls, vs rates of 9.1 per 10,000 population and 1.2%, respectively, among boys.

For self-reported self-injury, the mean rate was 275 per 10,000 population, and the annual relative rate increase was 2.5%. Overall, the data highlighted a consistent rise in self-injury rates among children and youth, with a greater trend observed among female vs male patients.

“Our findings emphasize the need for tailored, accessible support systems for youth, alongside a concerted effort to reduce stigma and improve prevention and early intervention strategies,” wrote investigators.

References

1. Saunders N, Benjamin H, Pechlivanoglou P, et al. Long-term trends in pediatric self-injury in high-income countries: a systematic review and meta-analysis. JAMA Pediatr. Published online March 16, 2026. doi:10.1001/jamapediatrics.2026.0217
2. Gardner W, Pajer K, Cloutier P, et al. Changing rates of self-harm and mental disorders by sex in youths presenting to Ontario emergency departments: repeated cross-sectional study. Can J Psychiatry. 2019;64(11):789-797. doi:10.1177/0706743719854070