The social environment can exert a positive, or in some cases a negative influence on youngsters prone to self-harm. For example, experts in adolescent mental health increasingly talk about the contagious effect on girls of exposure to other cutters, whether friends or acquaintances found through the Internet.
On the positive end, though, Patton suggested that "social scaffolding" can be a bulwark against self-harm. "Young people are going to be most protected from self-harm by good connections, and good involvement with their families ... with schools, engagement with their local neighborhood, and good relationships with their peers."
At the news conference, Keith Hawton, director of the Center for Suicide Research at Oxford University, and co-author of accompanying commentary in The Lancet, said the latest study captured part of "a hidden population" in the community, where many never seek professional help. Unlike self-harmers who land in hospitals after overdosing, self-harmers living under the radar in the community tend to hurt themselves in other ways, often known only by their closest friends.
With an estimated 6 percent to 10 percent of all teenagers engaged in self-harm, "the numbers are huge. It represents much distress," he said.
"The crucial question is: what is the significance of self-harming behavior in these mid-teenage years for subsequent mental health and future self-harming behavior, and indeed suicide?" Hawton said. He credited Moran and his colleagues with making "a special contribution" to what's known about the influence of self-destructive teenage behavior on future mental health.