Health service fails patients locked in a cycle of self-harm

"I need to self-harm as I need to breathe. It's my only release from the mental pain." In the words of Maria, 26, the raging desire to escape from the anguish of an abusive childhood has led to a decade of increasingly brutal self-harm.

"I need to self-harm as I need to breathe. It's my only release from the mental pain." In the words of Maria, 26, the raging desire to escape from the anguish of an abusive childhood has led to a decade of increasingly brutal self-harm.

From burning cigarettes on her skin to drinking acid, she is aware of being trapped in a vicious cycle of causing increasingly extreme pain. Her most recent self-harm led to 42 stitches as a result of a series of gouges in her arms.

The case of Maria is symptomatic of a burgeoning population of self-harmers who account for an alarming number of hospital admissions.

For Maria, who lives alone and has separated from her husband, the self-harm started at the age of 16 after a history of abuse during her childhood.

It began with mild gashes to her wrist and aspirin overdoses before worsening three years ago after the death of her father. There have been dozens of suicide attempts and she is aware that she is caught in a cycle of self-harm, at times hurting herself as often as several times a week.

Beyond the physical pain of her actions, one of the most difficult consequences of the cycle of violence is the reaction of healthcare staff.

Describing her case, Marjorie Wallace, chief executive of Sane, the mental health charity, said: "She sometimes drinks acid, she sometimes burns her arm with cigarette ends. She says that she can't stop herself and she is stuck in a cycle, like a physical addiction.

"What she really wants is to be admitted to hospital but when she goes to accident and emergency, they send her home and tell her to throw away razor blades and tablets."

Maria, which is not her real name, is currently following the advice of Sane and trying to call the organisation's helpline instead of self-harming.

But as in the case of Maria, for many self-harmers, there is a feeling that the stigma persists among healthcare workers and members of the public alike. And the low self-esteem that prevents them from seeking help results in the majority of incidents taking place in private.

In one anonymous account on the internet, a girl paints a poignant picture of her history of self-harm, which began at the age of 15, prompted by feelings of anger, low self-esteem and depression. "I began with a pair of blunt scissors. Then I progressed to a disposable razor. I found ways to manipulate the razor so it was easier to hurt myself. Eventually I went out and bought myself a pack of blades." She added: "I started to feel that I deserved the pain. When I felt unbearably angry or upset, I hurt myself. It made me feel real. Alive. Valid. My feelings must be important if I'm hurting myself. It can't just be teenage angst if there's blood and scars."

Charities have warned that children as young as seven are now self-harming, and also point to an alarming rise in the trend among men in their twenties and thirties. One of the most infamous exponents of self-harm was Manic Street Preachers' songwriter and guitarist Richey Edwards. He eventually disappeared and is believed to have committed suicide.

Sane helpline: 0845 7678000

SELF-HARM: THE FACTS

• Self-harm describes an act of someone deliberately injuring themselves;
• It is now in the top five causes of acute medical admissions in hospitals;
• One in two young people who commit suicide carried out an act of self-harm in the preceding year;
• The youngest reported incident of self-harm is a seven-year-old - on average, self-harming starts at 13;
• Seven times as many young women as men are self-harmers, according to the Royal College of Psychiatrists;
• Half of all self-harmers are discharged without proper assessment, according to the National Institute for Clinical Excellence.