Self-harm and suicide prevention - University of Birmingham

Research at the University of Birmingham is focusing on understanding, preventing and responding to self-harm and suicide in young people. The team is developing evidence-based interventions, influences policy and improves mental health support through partnerships with healthcare, community and voluntary organisations.

Background to our research

Suicide is a global public health concern and one of the leading causes of death in young people worldwide. Many young people face challenges that increase their risk of self-harm and suicidal behaviours.

Our work within this research theme, focuses on understanding and tackling these underlying difficulties. We aim to transform research, clinical practice, policy and community responses to self-harm and suicide prevention with a shared vision of developing effective, evidence-based interventions that support young people.

Please contact the Self-harm and Suicide Prevention Research Theme Leads for further information:

Research theme lead - Dr Maria Michail
Research theme co-lead - Dr Anna Lavis

Our research on self-harm and suicide prevention

ATTUNE: the role of the voluntAry secTor to the prevenTion of sUicide among youNg pEople

Key People: Dr Maria Michail

Voluntary organisations play a crucial role in supporting young people from marginalised groups who are at higher risk of suicidal thoughts and self-harm. ATTUNE examines how these organisations support at-risk young people in the West Midlands and South West Peninsula (England) and aims to develop best practice recommendations for effective collaborative care in youth suicide prevention.

Self-harm In Eating Disorders (SHINE)

Key people: Dr Anna Lavis

The SHINE study was a two-phase mixed methods feasibility study which aimed to understand the socio-contextual factors that underlie self-harm in eating disorders. We employed ecological momentary assessment methods and qualitative interviews with people aged 16+ attending specialist outpatient eating disorder services. This work has been presented at the International Conference for Youth Mental Health (Copenhagen, 2022) and the International Association for Suicide Prevention (Piran, 2023). This study is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (NIHR201108; 2021-2023).

Find out more about SHINE.

SEYMOUR: System Dynamics Modelling for Suicide Prevention

Key people: Dr Maria Michail

Tackling youth suicide rates with a novel system dynamics modelling approach.

Suicide is a leading cause of mortality among young people aged 15-29 globally. The EU-funded SEYMOUR project explores how systems modelling and simulation can inform strategic decision making for suicide prevention in young people aged 12-25 in Australia and the UK.

Find out more about SEYMOUR.

Exploring self-harm and suicide online content

Key people: Dr Anna Lavis

Since 2018, funded first by Wellcome, and subsequently by Samaritans and the Barker Family Trust, we have undertaken a series of studies exploring online self-harm and suicide content. Using the methodology of online ethnography, this research has explored both the impact of these content forms on young people, as well as motivations for engaging with them. Our findings have underpinned policy, such as inputting into the UK Online Safety Act, and practice across a range of sectors.

Suicide prevention and helplines

Key people: Dr Maria Michail

NSPCC Childline is the biggest helpline in the world, receiving approximately 300,000 substantive interactions each day via their website or by phone. The amount of online contact made through Childline is increasing, and now approximately 75% of all contact-making takes place via instant messaging, email and the website’s message board. We are working with the NSPCC to help the charity in its response to children who are at risk of suicide.

We reviewed existing Childline policies and practices and carried out focus groups and interviews with frontline staff at Childline and other helpline organisations across the world. The aim is to ensure Childline’s ability to assess and respond to suicide risk is informed by the best available evidence, and to ensure staff and volunteers have the best possible skills and the confidence to provide advice, support and to make referrals, where appropriate, to other frontline services.

Learn more about this research.

Suicide prevention in primary care

Key people: Dr Maria Michail

Primary care is often the first and last healthcare contact for those who die by suicide, including young people. We developed and evaluated evidence-based guidelines, training, and resources to support General Practitioners (GPs) in the assessment and management of vulnerable young people in primary care. We did this by:

Developing an electronic clinical decision support system for the assessment and management of suicide risk in primary care.
Creating an online education resource, Suicide in children and young people: Tips for GPs, in collaboration with the Royal College of General Practitioners (RCGP), to provide GPs with evidence-based recommendations about how to assess and mitigate suicide risk in a consultation.
Co-producing with the Institute of Mental Health Youth Advisory Group, #MyGPguide –an evidence-informed resource for young people with lived experience of self-harm and/or suicidal behaviour to prepare them for their consultation with their GP.
Creating a Special Interest Group Suicide Prevention in Primary Care co-chaired by Dr Maria Michail.

PhD Research

Understanding self-harm in dance

Maria is a Doctoral Candidate at the School of Sport, Exercise and Rehabilitation Sciences. She received her undergraduate degree in Psychology and MSc in Clinical Mental Health Sciences before embarking on her ESRC-funded PhD. Her work on the Understanding Self-Harm in Dance project explores how self-harm is conceptualised in dance and identifies gaps and opportunities for supporting dance students who self-harm. The research focuses on dance teachers and students’ perceptions and experiences of self-harm with the aim of co-producing educational resources to help safeguard those at risk within dance.

PhD Student:

Maria Kolitsida

Supervisors:

Professor Jennifer Cumming
Dr Anna Lavis
Dr Erin Sanchez from One Dance UK (Industry Supervisor)

Connect with Maria: LinkedIn

Investigating the social determinants of youth suicide and self-harm

Adam is a PhD student at the School of Psychology. His ESRC-funded PhD project aims to investigate the broader social, political, economic and environmental factors that influence self-harm and suicidal thoughts and behaviours among young people aged 16 and 25 in England. The research explores this through a mixed-method approach with the end goal of producing evidence-based recommendations to inform future research and policy efforts.

Project website.

PhD Student:

Adam H G Chen

Supervisors:

Impact & knowledge exchange

Supporting children with their mental health

Transcript

Today's event matters because it brings people together around a shared commitment, ensuring that young people who experience self-harm and suicidal thoughts can receive support which is timely, compassionate and joined up.

I was inspired to work with colleagues across Cheshire East because of the sustained leadership, commitment, and genuine desire to co-produce solutions with young people, families, health professionals and the voluntary sector.

We know that we've got issues around the numbers of people with mental health concerns and who are self-harming and having suicidal thoughts.

So, an opportunity to bring them together and to talk about‚ what are the better ways of offering support to those young people and their parents and carers, is a really great opportunity for us to just get people into a room and have those conversations.

I think what we need is young people to be incorporated into this, because experiences with mental health aren't just black and white, there's a lot of grey areas and there's a lot of in-betweens, and it's a spectrum in many ways, and it's very, very complex.

#MyGPguide could help young people feel a lot more confident about talking to their GP, because it can clear up a lot of misconceptions, just like we discussed in the event, there's a lot of misconceptions and barriers around contacting a GP.

So, I think that general practice has a really important role in supporting children and young people with self-harm and suicidal thoughts.

I think #MyGPguide will be an excellent tool to support young people to engage more confidently with their GP around self-harm and suicidal thoughts.

It's been developed by young people who understand the challenges and the barriers that they may face, and because of that, it hopefully reduces some of the worries that young people might have in advance, enabling them to have the most effective consultation possible.

When we, in the Self-Harm and Suicide Prevention Board, became aware of the #MyGPguide, we were really interested in what it was presenting in terms of advice and guidance to young people and their parents and carers, and we were keen to find out more about it.

Maria came and talked to us at one of the meetings, and after that we were of the view that we needed to incorporate it into our action plan, because it provided a really good resource for children and young people, parents and carers, to help them if they were facing the issues set out in the guide and to prepare them for being able to access GPs appropriately.

Similarly, we have started to share it with GPs to make them aware of it and to help them to be prepared to receive those sorts of queries and concerns from young people.

Whilst I'm not a GP currently, I did qualify as a GP and practised as a qualified GP prior to becoming a consultant in public health, and I can say that I would have found this resource really, really helpful in helping me to understand what young people might be feeling when they're seeking support in terms of self-harm or suicidal thoughts, to make sure that I was providing them with the most effective support possible.

Looking ahead, I hope today's event makes young people more empowered and equipped to seek help from their GP when they're experiencing self-harm or suicidal thoughts.

On 10 July 2026, the Institute for Mental Health, in partnership with Cheshire East Council, hosted a full‑day conference focused on strengthening support for children and young people’s mental health. The event brought together colleagues and partners from across the system to explore how we can improve mental health outcomes, reduce stigma, promote early intervention, and build more responsive, compassionate support for children, young people, and families.

The video captures key highlights from the event, showcasing shared learning, lived experience insight, and the collective commitment to strengthening mental health support across Cheshire East.

Stronger together: empowering community action to prevent youth suicide

Transcript

Stronger Together is about confronting the realities of youth suicide.
And what inspired us to do this event today is the power of lived experience.

I have seen in my research first-hand how many young people and their families often feel unheard, unseen, and unsupported, at the time of
when they are most vulnerable.

We are hoping to bring together practitioners, those with lived experience, family members and researchers, to have an open conversation and dialogue about the complexities behind youth suicide.

Youth suicide is something that's increasing.

Everyone's going to have a different experience.

I think the more people researchers talk to, the more they're going to hear different perspectives and how it affects different people.

When it comes to youth suicide prevention, it can be quite a hard conversation to have with young people.

As the days go by, the numbers are always going up.

So, it's important that lived experience people are being included in the research project and I guess empowering us to make our voices heard.

If there was one thing to take away, it would be what's behind that smile?

What are they really saying?

So, I think if we can really be mindful of psychological safety, I think if there's one thing, it is that. All any of us want to do is help and support.

We're all in this together.

My one takeaway would be don't give up hope.

I find it encouraging.

We've been missing the voice of the young people for a long, long time.

I think lived experience is an expertise that you can't get from any data or any form of journal articles, it is something that is so fluid and unique to each person.

The key challenge sometimes is the disconnect between young people's lived experience or the systems that are in place that are meant to support them.

There are many young people who do not seek help when they are experiencing self-harm or suicidal thoughts, because of the shame
and the stigma attached to suicide.

Those who do seek help are often faced with many challenges in accessing the right help and support when they need it.

I know when I was younger, like a teenager, I had no idea about mental
health research.

I had no idea what it was, what was happening in it.

I didn't realise that it was kind of doing research into things

I was going through, and I think being someone with lived experience, you obviously understand it from an almost like insider perspective.

And I think using that to help shape research, whether it‚ thinking about proposals or ethics applications or research questions or topics or whatever it is, I think it just brings a different perspective.

I think in terms of the key takeaways was just everything, the whole event, and actually the safety around, you know, you provided
such a safe and nice, a warm platform for everybody to share and to open up the panel as well, you had a mixture of different people, different disciplines.

For people in the room, I hope this event will make them feel more heard, seen, and empowered to take action in their local communities.

For the wider community, I'm hoping that this event will change the narrative of suicide and the public dialogue, seeing a shift from silence
and stigma to compassion and care.

The Institute for Mental Health, in partnership with The Hopeshow, a national awareness campaign focused on reducing stigma, brought forward the lived experiences, research insights, and community action needed to prevent youth suicide. The video above captures highlights from Stronger Together, focused on youth suicide prevention. The event brought together young people, bereaved parents, voluntary, community and social enterprise (VCSE) organisations, researchers, clinicians, and representatives from schools and youth services.

Through a panel discussion and open conversation, speakers and audience members shared perspectives and experiences, reflecting on the challenges around youth suicide and the importance of working together across communities, services and research to better support young people and those affected by suicide.

Following the panel, young people with lived experience took part in a photovoice activity exploring what gives them hope. Through images and reflections, they shared the people, places and everyday moments that support their wellbeing and resilience. These contributions highlight the importance of listening to young people’s voices and recognising the strengths and connections that can play an important role in suicide prevention.

Policy recommendations

Strengthening support for young people: A cross sector approach to suicide prevention (May 2026)

ATTUNE Study Report Policy Booklet (PDF, 11.40 Mb)
Accessible version - ATTUNE Study Report Policy Booklet (word, 141 Kb)

Executive summary

Young people are less likely to seek help from statutory services and when they do, they often face long waiting lists due to capacity and workforce pressures. However, they report feeling more able and willing to access support from voluntary, community and social enterprise (VCSE) organisations.

The ATTUNE study looked at how:

To understand young people’s experiences of seeking and receiving support from the VCSE when facing self harm or suicidal thoughts and behaviours, across diverse regional contexts.
To examine how the VCSE and statutory sectors interface, including how they work alongside each other, and barriers and facilitators to collaborative care.
To co produce best practice recommendations for strengthening collaborative care between the VCSE and statutory sectors in youth suicide prevention.

Working in partnership with young people with lived or living experience of self-harm or suicidal behaviours, statutory and VCSE sector professionals, we co produced 29 best practice recommendations, organised into 5 priority areas with 9 associated actions, that translate the recommendations into practical steps for strengthening collaboration between the VCSE and statutory sectors.

Preventing suicide in young people (March 2019).

Executive summary

Primary care is often the first and last health-care contact for those who die by suicide, and 50% of surveyed GPs had not undertaken any mental health training in the previous 5 years.
Young people with first-episode psychosis have significantly higher rates of self-harm, the strongest risk factor in suicide.
Factors increasing the likelihood of self-harm included psychiatric history, a history of childhood sexual abuse, and increased risk for young people from Black, Asian and Minority Ethnic Backgrounds. Females and younger patients were also more likely to self-harm.
Key recommendations include: the need for early intervention to reduce later risk, and the roll out of regular mandatory training for GPs and other healthcare professionals on suicide awareness and risk management. Suicide risk management should be a mandatory part of a GP NHS revalidation cycle.

Developing educational resources and recommendations

Suicide in children and young people: Tips for GPs – RCGP educational resource

It can be difficult to undertake a comprehensive mental health assessment of a young person in the context of the competing demands of general practice. Tips for GPs offers some suggestions specifically about how to assess and manage suicide risk in a consultation, acknowledging that more detailed mental health assessments may need to take place over multiple consultations and with input from other services.

View the resource.

#MyGPGuide – a guide to talk to your GP

We know that visiting your GP to talk about self-harm and suicidal feelings can be very frightening. This is because you might not know what to expect. We have put together a short guide to help young people prepare to talk with their GP about self-harm and suicidal experiences.

This has been developed by researchers at University of Birmingham in partnership with a group of youth advisors.

Read the Guide (PDF).

Watch a short video about MyGPGuide

Latest news and events

World Suicide Prevention Day

We’re currently planning a campaign to showcase the recent and ongoing research within the self-harm and suicide prevention research group. Keep an eye on this space.