Our findings are consistent with follow-up studies of people with self harm presenting clinically, which have found an increased risk of psychiatric disorder, future self harm, and substance use problems in adulthood,6 7 compared with those without a history of self harm. We extended this by investigating outcomes in a population based sample of adolescents. Such studies are of critical importance as most acts of self harm do not present to specialist services3; for example, in the present sample, only 8.4% of respondents reported having sought medical help from a doctor or hospital department after their most recent self harm act. Our findings are also consistent with longitudinal population studies, which have found associations between adolescent suicide attempts and poor outcomes in adulthood.11 12 We provide an extension to this previous work by differentiating between self harm with suicidal intent and self harm without suicidal intent. This is important, as the extent to which suicidal and non-suicidal self harm should be considered different diagnostic categories is a source of debate,13 14 15 16 and non-suicidal self injury has now been
