Self-harm – The Secret Epidemic Afflicting Scotland’s Older People

A hidden epidemic of self-harm among older people exists in Scotland, with thousands of cases admitted to hospital each year and many more covering up their injuries, mental health campaigners have warned. Support groups for self-harmers report growing numbers of cases emerging among people in their 40s, 50s and 60s.

The scale of self-harm in older people is unknown because they are much less likely to come forward for help because of the stigma around mental health issues. But campaign groups believe it may be just as big a problem as self-harm among teenagers – the group usually associated with cutting, burning and hurting themselves to deal with their feelings.

Figures suggest there are between 14,000 and 16,000 admissions a year to hospitals in Scotland as a result of self-harm.

Three-quarters of these are under-45s, the vast majority of them teenagers. About 3,000 admissions are among older people, but it is believed many more may be self-harming but have become better at covering it up and coping with their injuries themselves.

Patrick Little, of the mental health organisation Penumbra, which runs projects across Scotland, said it no longer only worked with youngsters self-harming.

“One of our projects works with people aged 18 and upwards and we are working with 60-year-olds who have lived their lives in pain,” he said.

“They will have started when they were young and lived their lives self-harming. I would say this is not as uncommon as people think. I have been saying that maybe we need to start looking at self-harm in the elderly because it’s an issue that is there.”

Mr Little said a lot of people’s first experience of serious pain may be when they become elderly and lose their partner or when their own health starts to fail.

“I have no doubt that if you started to dig there you would start to uncover new self- harm among elderly people,” he said. “People who are not young and self-harm often feel more ostracised because it is felt that this is a young people’s issue and they shouldn’t be doing this. Our understanding is that if this is a response to emotional pain it shouldn’t matter what age you are.”

Mr Little said it was estimated that only around one in ten incidents of self-harm resulted in someone going to hospital.

Linda Dunion, campaign director for the Scottish mental health group See Me, said self-harm among older people was a particular concern because it remained hidden.

“It is something that has come to our attention recently. Because it is so associated with young people the general public don’t actually realise that it does affect older people as well,” she said. “Self-harm in older people is probably underestimated. It tends to be really hard for older people to come forward and get help.{mospagebreak}

“It is such a hidden problem that we are only now beginning to question how many older people may be involved. If they are not going for help they are not being counted.”

Lindsay Scott, of Help the Aged Scotland, said older people had to deal with difficult issues which could lead to mental health problems and self-harm.

“With the breakdown of the family unit, more and more older people are finding themselves in a state not just of poverty but also of isolation and neglect,” she said. An isolated pensioner who has no-one to talk to, very little money and the worry of bills to pay could find themselves pushed into a corner.”

A Scottish Executive spokeswoman said: “We are aware that self-harm can be an indicator of mental ill health. We have a range of measures in place to improve mental health and wellbeing for all and one priority area is to improve mental health and wellbeing in later life.”

‘At 41 you are meant to be in control’

Karen Martin began self-harming in her twenties. Now 41, she is still struggling to deal with the cutting and scratching that has become part of her identity. She said the stigma of being an older self-harmer meant many in their forties, fifties and sixties were unlikely to seek help.

“It makes me feel numb and is a way of controlling my emotions. But that feeling may only last a few minutes and then I either have to cut myself again or distract myself.”

Ms Martin’s self-harm came to a peak about six years ago when she was in an abusive relationship. “My self-esteem was rock bottom. The only way to control my anger was to let it out by cutting.

“People think when you get to my age you are supposed to be in control of yourself and you shouldn’t be resorting to this type of behaviour. But it’s not an attention-seeking act. It’s a controlling mechanism when something else in my life is out of control.”