Introduction

Suicide attempts and self-harm behaviour in young people are sadly not uncommon. In the UK alone, statistics suggest that ‘10-13% of all young people between the ages of 11 and 16 are affected by self-harm’, and figures published in 2014 suggested 70% more attendances to hospital accident and emergency departments by 10 to 14-yearolds in the two years preceding this (www.selfharm.co.uk). In fact, a study by Whitlock in 2012 suggested that the number of young people affected could be as high as 20% (PLoS Medicine, volume 7, issue 5). Worryingly, this increase is occurring against a backdrop of increased demand and decreased resources in Child and Adolescent Mental Health Services (CAMHS). This means that low-level self-harming behaviours may well be being missed when they are more likely to be responsive to treatment, leading to an increased likelihood of these behaviours escalating and becoming more entrenched.