The families of young people who self-harm need more support to deal with the impact it has on their own mental health and relationships, according to a new study led by Keele University.

Self-harm in young people is a serious international health concern with an estimated 26% of young people having self-harmed previously. But while attention has rightly focused on helping people in distress, the needs of parents, family members, friends, carers and even neighbours providing informal support are often overlooked.

In a first-of-its-kind study, Keele University researchers, supported by the National Institute for Health and Care Research (NIHR) School for Primary Care Research, studied data looking at the experiences and needs of those closely linked to young people, aged 12 to 25, who have harmed themselves. The study was carried out in collaboration with University College Cork, Ireland, and the Universities of Oxford and Nottingham.

The review included 22 papers published between 2002-2021, with some participants highlighting how it had changed their sense of identity and in turn influenced their relationships, with one mother explaining she had become more of a therapist to her daughter.

Other parents felt guilty because of self-harm as they thought they had failed as parents, while participants also reported suffering sleeplessness, depression and anxiety. Most said they would value accessible information on self-harm to help them understand, offer appropriate support, and inform decision making.

Sharing their findings today in eClinicalMedicine, published by The Lancet, the researchers, have suggested seven recommendations that call for more support by healthcare professionals and services. These include better communications from healthcare professionals to parents, carers and families, help for individuals to cope with new identities and more readily available and clear information on why young people might self-harm.

Lead author Dr Faraz Mughal, GP and NIHR Doctoral Fellow from Keele University, said: "This systematic review and thematic synthesis, the first to our knowledge to focus solely on parents, friends, and families, identified that these supporting individuals sought to understand self-harm in young people, and highlighted the substantial impact self-harm had on their mental health and approaches to parenting.

"Parents and friends described how self-harm affected their self-identity and that this strengthened or weakened relationships. A key theme generated was on parents and families attempting to manage self-harm through seeking help, leaning on therapies, peer support and schools. It illustrated an unmet need for accessible information to assist them in their role as supporting individuals.

"Young people often turn to these supporting individuals for help, and therefore responses of such individuals are vital for the future help-seeking of young people to reduce repeat self-harm, emotional distress, and suicide and mortality risk.

"Healthcare professionals, services, and systems must recognise that these supporting individuals have distinct needs and they can address these through our review-informed recommendations. It is crucial for health policy to provide resources and funding to facilitate the implementation and evaluation of these recommendations."