The number of young people in Singapore seeking emergency medical care for self-harm and suicide attempts increased significantly in 2021, highlighting growing concerns over adolescent mental health. A recent study analysing cases at KK Women’s and Children’s Hospital found that most of those affected were teenage girls, with a notable trend in self-harm linked to emotional distress and stress-related factors. The findings were published in the journal Annals.
The study reviewed the medical records of 221 patients aged between 10 and 19 who were admitted to the hospital’s emergency department for self-harm or suicide attempts in 2021. The findings revealed that 85.5 percent of the cases involved female patients, with an average age of just over 14 years. The most common method used was intentional drug overdose, primarily involving paracetamol. Other methods included self-laceration and, in some cases, jumping from a height, which was more commonly observed among boys.
The research found that nearly three-quarters of the adolescents had a history of non-suicidal self-injury, with many also having previous suicide attempts. Stress-related difficulties and emotional coping challenges were identified as the most prevalent mental health issues, followed by mood and anxiety disorders. Notably, the study pointed out that these adolescents were not necessarily experiencing severe psychiatric illnesses but were often struggling with psychosocial stressors, particularly family conflict, academic pressure and difficulties with peer relationships.
There was a seasonal trend in the data, with a spike in cases between July and October, coinciding with the second school semester and year-end examinations. The lowest number of cases was recorded between April and June, a period that included the mid-semester break. This pattern suggests that academic stress plays a significant role in adolescent mental health challenges. The study also noted that the impact of Covid restrictions in 2021 may have exacerbated feelings of isolation and distress among young people.
Further analysis indicated that prior healthcare visits were common among those who later presented with self-harm or suicide attempts. Many had previously sought medical attention for unexplained physical symptoms, mild medical conditions or earlier incidents of self-harm. The study suggested that these healthcare visits could be opportunities for early identification and intervention, as frequent medical consultations for non-specific complaints might indicate underlying mental health distress.
The findings also underscored sex-specific risk factors. Girls were more likely to present with paracetamol overdoses and eating disorders, while boys exhibited higher rates of neurodevelopmental disorders such as autism spectrum disorder and were more prone to excessive screen time. Such distinctions could inform more targeted mental health strategies to address different risk factors between boys and girls.
The study’s authors called for enhanced mental health support in schools and communities, proposing that early screening and targeted interventions could help mitigate risk factors. They suggested that transdiagnostic psychological interventions focusing on emotional regulation and resilience building might be particularly beneficial in reducing self-harm incidents among young people. The findings contribute to growing discussions on how best to support adolescent mental health and prevent self-harm cases from rising further.
