Self harming is common amongst school pupils anxious about their sexual orientation, according to a study.

Research carried out by the Samaritans, the Centre for Suicide Research at the University of Oxford and the University of Bath found that girls are four times more likely to have engaged in deliberate self-harm compared to boys, with worries about sexual orientation being one of the contributing factors.

The survey of 6000 pupils aged 15 and 16 found that 11 per cent of girls and 3 per cent of boys reported that they had self-harmed within the last year.

For both sexes there was an incremental increase in deliberate self-harm with increased consumption of cigarettes or alcohol, and all categories of drug use.

Self-harm was more common in pupils who had been bullied and was strongly associated with physical and sexual abuse in both sexes.

Approximately 3% of the children admitted having worries about their sexual orientation, the research said: “Females who were worried about their sexual orientation were four times more likely than females without such worries to report deliberate self-harm and males with such worries were more than twice as likely as other males to report deliberate self-harm.

“In neither gender, however, was an independent association with

deliberate self-harm found. This may well reflect the relatively low rate of reporting of these concerns.”

Previous estimates for the amount self-harm in the country were based on the 25,000 “presentations” at hospitals in England and Wales each year that are the result of deliberate self-poisoning or self-injury amongst teenagers.

However, this research found that only 13 per cent of self-harming incidents reported by the pupils had resulted in a hospital visit.

Although self-poisoning is the most common form of self-harm reported in hospitals, the study revealed that self-cutting was the more prevalent (64.5 per cent), followed by self-poisoning through overdose (31 per cent).

Karen Rodham from the Department of Psychology at the University of Bath is co-author of the study, she said: “The study shows that deliberate self-harm is common amongst teenagers in England, especially in girls who are four times more likely to self-harm than boys.

“Until now, most studies of deliberate self-harm in adolescents in the UK have been based on the cases that reach hospital.

“We have found that the true extent of self-harm in England is significantly wider than that.”

Professor Keith Hawton from the Centre for Suicide Research at the University of Oxford, who directed the project, said: “This study provides more information about why young people engage in deliberate self-harm and helps us to recognise those at risk, to develop explanatory models and to design effective prevention programmes.

“In many cases, self-harming behaviour represents a transient period of distress, but for others it is an important indicator of mental health problems and a risk of suicide.

“It is important that we develop effective school-based initiatives that help tackle what has become a most pressing health issue for teenagers.”

The research has been published in a new book, By Their Own Young Hand, which includes practical advice for teachers on how to detect young people at risk – based on the evidence collected by the academics.

The book also suggests advice on coping with the aftermath of self-harm or attempted suicide in schools, and advice on designing training courses for teachers.

The research took place in 41 schools in Oxfordshire, Northamptonshire and Birmingham in 2000 and 2001.

Pupils were asked to complete a 30 minute questionnaire which explored issues surrounding self-harm and suicidal thinking – together with other personal factors such as depression, anxiety, impulsivity and self-esteem.

Those who reported self-harm were asked to provide a description of the act, its motivation and its consequences.

“The reasons why boys and girls decide to self-harm are varied but the most frequent motive expressed by both males and females was as a means of coping with distress,” said Dr Rodham.

The vast majority of pupils said that their friends were the people they felt that they could talk to about things that bothered them and those who had self-harmed most often turned to their friends.

“This responsibility places a great burden on adolescents to support their peers, yet most adolescents have not in any way been coached in how best to do this,” said Professor Hawton.

“Attention to this aspect of support for adolescents should be an essential part of mental health education in schools, and it is great to see the development of the wellness programmes currently being tried in some schools.

“Whilst effort to encourage adolescents to seek help through friends, family, help lines and clinical services are very relevant, prevention should be focused on reducing the problems that lead to thoughts of self-harm.

“This is where school-based initiatives can make the most important contribution to this important aspect of mental health.”

Ben Summerskill, chief executive of gay charity Stonewall, told PinkNews.co.uk: “We know that anecdotally self-harming is much more widespread than is often acknowledged. Children who are bullied are more likely to self-harm and this means that those who are lesbian or gay are at high risk. Stonewall’s current survey for school pupils is one attempt to start creating a body of evidence of the extent to which these often hidden incidents are happening.”