and treatment of adolescents who self harm, regardless of the history of suicidal intent, to alleviate current distress and reduce the risk of future problems. The strong associations with later mental health and substance use found in this study suggest that interventions aimed at reducing self harm behaviours should also focus on treating or preventing these additional problems. This approach may help to reduce the risk of future suicide among young people who self harm, as studies have suggested that those with a history of self harm are more likely to die by suicide if they have mental health or substance use problems.8 41
