Social media is not the main culprit in the rise of self-harming among boys, says a former mental health worker. In fact, it may be their saviour: we have been ignoring boys’ calls for help for too long, says Katherine Denkinson

Leo* moved into our residential care home at 14 years old, having been removed from his parents’ home following neglect. He was no longer attending school and spent the majority of his time online, listening to music and gaming.

As with all of the young people who came to stay at the home where I was working, he had a number of mental health and behavioural issues (including self-harm) which we began to work through.

For Leo, self-harm was a way to feel like he had control of a life which had become increasingly chaotic. It gave him a way to externalise his feelings of anger and to generate a response from the adults around him, who had often not acknowledged him unless they had to.

Leo’s social worker informed us he was an active member of online groups which discussed self-harm and often posted graphic imagery of cuts and paraphernalia. They believed he had begun harming as a result of the groups and advised that we restrict his internet use to prevent this from worsening.

But there was a nuance to this situation. A report this week announced that self-harming by boys had increased by 50 per cent in just four years, prompting warnings over role of social media.

The study conducted every four years by British academics in conjunction with the World Health Organization found almost one in six 15-year-old boys (16 per cent) in England said they had self-harmed, up from 11 per cent in 2014.

Still, we shouldn’t be so quick to blame social media as the cause of the rise in self-harm. After several months of working with Leo, we realised that he was not using the groups as inspiration to self-harm. His emotional trauma and desire to harm had already been present when he sought out the groups as a way to connect to other young people in his situation.

Given his lack of real-life friendships, we opted to allow him to continue accessing them, provided he was supervised by staff. After each internet session, he was given a chance to talk about the things he had read and seen to help him develop trust and verbalise his feelings. Over time, his incidences of self-harm were significantly reduced.

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The statement that self-harm in boys has risen 50 per cent over the last four years is not surprising. Historically, boys had been thought to self-harm at half the rate of girls. The truth is that boys are simply far less likely to speak about self-harm and depression and are also more likely to hide evidence that they are self-harming.

There is also the problem of presentation. Self-harm in girls presents classically as cutting or starving. For boys, self-harm can include these things, but is just as likely to include drug and alcohol abuse or persistently getting into fights.

Lewis* fit this pattern. Aged 15 he came to us directly from a young offenders’ institute. He came from a family of career-criminals and an impoverished home life. Prone to absconding, his preferred method of self-injury was to indulge in drugs, alcohol and fighting.

If boys like Lewis presented to A&E with razor slashes down their arms, alarms would be raised. The presence of bruised knuckles and a hangover creates no such issues. It is assumed that such injuries are par for the course with teenage boys. Add in a home environment where they are discouraged from discussing their feelings, or derided for showing “weakness” and the lack of accurate stats becomes depressingly clear.

Andrew Przbylski of the Oxford Internet Institute, undertook a large-scale study in 2017, which showed that screen-time and internet use in adolescents only had a detrimental effect on mental health at the most extreme end of the spectrum. Young people who spent an excessive amount of time online were more likely to experience negative mental health effects, whereas those who spent an average amount of time online suffered no ill effects and, in some cases, found the experience improved their overall well-being.

Dr Raj Persaud, a consultant psychiatrist, believes that the lack of mental health services for young people has created a void; he says that young people “turn to the internet when the real world services are difficult to access or…non-existent”.

This experience is echoed by James M. A qualified Mental Health Nurse (RMN) who spent six years on a Child and Adolescent Mental Health Services (CAMHS) unit, he believes that cuts to our mental health services created a situation where children “[have] learned that, in order to be listened to by CAMHS, their behaviour [needs] to escalate beyond saying they felt suicidal”.

Boys have always self-harmed, they were just unable to tell us and it is partly because of online groups that this has changed.

*all names have been changed.

What can parents do to help?

Remember: children do not begin to self-harm because they encounter an image on social media. Instead, they will seek out imagery to reinforce already negative feelings.

Most self-harm is a direct result of trauma or bullying. Let your children know that they can tell you if something is wrong.

Monitor the amount of time they spend online and the sites they are accessing. If something seems off, give them the chance to discuss it with you.

Do not assume that, because they are discussing negative topics, they are in danger. Often the anonymity of the internet creates a safe space for them to open up or to vent.

Check these websites and helplines for more information:

Mind, open Monday to Friday, 9am-6pm on 0300 123 3393

Samaritans offers a listening service which is open 24 hours a day, on 116 123

The Mix is a free support service for people under 25. Call 0808 808 4994 or email: help@themix.org.uk

Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org