Older adults who self-harm reluctant to seek support, study finds

Researchers at Keele University have explored the experiences and reasons for self-harm in older adults to improve the support and treatment that can be provided.

The PhD study, conducted within Keele’s Research Institute for Primary Care and Health Sciences, aimed to identify the underlying factors which led to older adults self-harming and explore their experiences of self-harm, with a view to helping clinicians to support patients in this situation.

The researchers conducted interviews with older people (aged 60 and over) who have engaged in self-harm, as well as support workers from the third sector such as mental health charities, in order to identify these factors and explore patients’ experiences.

Self-harm is the leading risk factor for suicide with higher rates reported among older people, and this research is believed to be the first of its kind to use qualitative methods to explore the experiences and reasons for self-harm in older adults.

The researchers found that self-harm is often concealed in older adults due to feelings of shame and stigma, which may lead older adults to not report their self-harm or seek support.

The research, published in The Lancet journal EClinicalMedicine, found that older people described different reasons for self-harm, with a variation in levels of suicidal intent reported amongst participants.

PhD student Isabela Troya Bermeo said: “This study is the first conducted with an older adult population that confirms that the relationship between self-harm and suicide is more complex than previously conceptualised, given that some older adults report engaging in self-harm behaviour to avoid suicide.

“This is an important finding for clinicians to consider when assessing older adults who self-harm. Our findings highlight that self-harm in older adults is often hidden, which may result in low levels of people seeking medical help.

“Self-harm holds no singular function for older adults, but clinicians should be aware of the existence of this behaviour in later life, and the heightened risk amongst those with mental and/or physical health conditions.

“It is important for clinicians supporting older adults who self-harm to engage with them, in order to understand their motivations for self-harming and to provide appropriate support and referral for further management.”

Professor Carolyn Chew-Graham, Isabela’s supervisor, emphasised the importance of this work, particularly in view of the NHS Long Term Plan (https://www.longtermplan.nhs.uk/) which highlights the need to recognise and manage mental health problems in older adults.

She said: “Isabela’s work will add to a growing body of literature on self-harm in older adults, highlighting this often hidden problem. The Royal Colleges of General Practitioners and Psychiatrists are currently working together to raise the profile of mental health problems in older adults and this study has implications for all clinicians working with older adults, as well as policy-makers and service commissioners.”