Sunday, March 16, 2025

Silent scars, hidden mental crisis: Why we must act on self-harm now

DR JASMIT Shah and WILLIE Njoroge discuss the rising cases of self-harm and what communities need to do to avert this mental health crisis from spilling out of control

BY DR JASMIT SHAH AND WILLIE NJOROGE

Behind closed doors, countless individuals fight an invisible battle, one that is too often misunderstood or ignored. For many, self-harm becomes an outlet for overwhelming emotional pain, a way to cope when words fail, and no other relief seems within reach. But instead of finding support, they often encounter stigma, judgment, or even outright dismissal.

Contrary to common misconceptions, self-harm is not just a cry for attention or an act of rebellion. It is a profound mental health issue, frequently linked to conditions like depression, anxiety, or past trauma. What is even more alarming is its connection to suicide; According to the World Health Organization, approximately 700,000 lives are claimed by suicide each year.

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Research published in the European Child and Adolescent Psychiatry journal on July 24, 2023, suggests that up to 17 percent of people globally engage in self-harm at some point, with teenagers and young adults being particularly vulnerable.

This global crisis is reflected in local research as well, a five-year study conducted from 2018  to 2022 at a tertiary hospital in Kenya by the Aga Khan University Brain and Mind Institute revealed that 28.1 percent of psychiatric patients reported self-harming, with overdose (68.8 percent) and self-injury (56.3 percent) being the most common methods.

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Family conflict was the leading trigger (39.6 percent). Women and young people were especially at risk, often grappling with underlying mental health conditions like depression and anxiety.

Despite the warning signs, many individuals suffer in silence, too afraid to seek help. Fear of judgment, misunderstanding, or even punishment keeps them from reaching out. Some don’t even recognize their behaviours as signs of deeper distress. By the time they seek support, they are often in crisis, yet our current approach to mental health remains largely reactive rather than proactive.

A key step in addressing self-harm is education. Many people including teachers, employers, and even families don’t recognize the signs or understand that self-harm is often a symptom of deeper emotional struggles.

Schools and workplaces should integrate mental health awareness programs, equipping individuals with coping skills and encouraging open conversations. When educators and employers are trained to spot signs of distress, they can provide meaningful support early, preventing situations from escalating.

Medical professionals play a crucial role, yet all too often, self-harm is treated purely as a physical issue, patching up wounds without addressing the emotional pain behind them. Healthcare workers need better training to provide psychological support rather than just emergency care. A shift towards long-term mental health treatment, rooted in empathy and understanding, is vital.

To tackle self-harm effectively, we need a clear picture of the crisis. Kenya currently lacks a national self-harm registry, making it difficult to track trends, risk factors, and the impact of interventions. With proper data collection, we can develop evidence-based policies and ensure mental health resources are directed where they are needed most.

Signs and patterns of suicide; how to help someone who is suicidal

For too long, mental health issues have been met with silence, shame, or dismissal. This only pushes people further into isolation. Open discussions in the media, in schools, and within families can help normalize conversations about self-harm.

When individuals feel seen, heard, and understood, they are more likely to seek help before reaching a breaking point. None of these solutions will be effective without proper funding.

Right now, Kenya allocates less than 1 percent of its health budget to mental health, leaving critical gaps in care, especially in rural areas. Expanding mental health services, training more professionals, and integrating mental health care into general healthcare settings are necessary steps toward ensuring help is accessible to all who need it.

We can no longer treat self-harm as an invisible crisis. Every statistic represents a real person; a son, a daughter, a friend, or a colleague struggling in silence.

But there is hope. By investing in mental health, educating communities, challenging stigma, and making support more accessible, we can change the course of this crisis. Every action, no matter how small, brings us closer to a society where no one has to suffer in silence.

Dr. Jasmit Shah is a Data Scientist at Aga Khan University’s Brain & Mind Institute
and Willie Njoroge is a Research Fellow at Aga Khan University’s Brain & Mind Institute

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