Self-Harm among Young People Detained in the Youth Justice System in Sri Lanka.

Lushan V Hettiarachchi,Stuart A Kinner,Rohan Borschmann,Holly Tibble

doi:10.3390/ijerph15020209

Abstract

Self-harm is prevalent in incarcerated adults, yet comparatively few studies of self-harm in detained youth (and even fewer in low- and middle-income countries) have been published. We examined the prevalence and correlates of self-harm in a sample of 181 young people (mean age 15.0 years, SD = 2.3) detained in the youth justice system in Sri Lanka. Structured face-to-face questionnaires assessed demographic characteristics, family and social background, substance use, self-harm history (including frequency, method, and intention), bullying victimization, physical and sexual abuse (victimization and perpetration), and exposure to self-harm/suicide by others. Seventy-seven participants (43%) reported a lifetime history of self-harm, 19 of whom (25%) who reported doing so with suicidal intent. Fifty participants (65% of those with a history of self-harm) reported engaging in self-harm impulsively, with no prior planning. A history of self-harm was associated with being female, prior sexual abuse victimization, prior exposure to self-harm by friends, and a lifetime history of self-harm ideation. High rates of substance use, bullying victimization, parental incarceration, and exposure to suicide were reported across the sample. Young people detained in the youth justice system in Sri Lanka are a vulnerable group with high rates of self-harm, substance use, and psychosocial risk factors. Strategies for identifying and preventing self-harm, and targeted psychological interventions designed specifically to address impulsivity, may contribute to more positive outcomes in this marginalised population.

Highlights

Self-harm and suicidal behaviours are common in adolescence in both high-income countries [1,2,3,4,5]and low- and middle-income countries [6,7,8] including Sri Lanka [9,10]
Risk factors for self-harm include a history of adversity in childhood, mental illness, and substance use [11], all of which are disproportionately prevalent in young people who come into contact with the youth justice system [12,13]
Participants in our study reported a high prevalence of sexual abuse, bullying victimization, and a range of parental risk factors including incarceration, substance use history, parental self-harm, family conflict, and parental abuse, highlighting the complex adversity that characterizes many young people in detention [52]

Summary

Introduction

Self-harm and suicidal behaviours are common in adolescence in both high-income countries [1,2,3,4,5]. Low- and middle-income countries [6,7,8] including Sri Lanka [9,10]. Risk factors for self-harm include a history of adversity in childhood, mental illness, and substance use [11], all of which are disproportionately prevalent in young people who come into contact with the youth justice system [12,13]. Most previous research has been conducted in high income countries, and has. Res. Public Health 2018, 15, 209; doi:10.3390/ijerph15020209 www.mdpi.com/journal/ijerph

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