The prevalence of suicidal thoughts and plans is similar to that in smaller studies from other countries [13,14], and indicates that thoughts of killing oneself are as common among teenagers as self-harm. Although the two are associated in this sample, the relationship is complex. The majority of self-harm behaviour appears to be non-suicidal in intent, with approximately three quarters not wanting to die the last time they self-harmed. Conversely, a minority of the sample had never self-harmed but had had suicidal thoughts, indicating that self-harm is not a necessary precursor to or outcome of suicidal thoughts. There was evidence that self-harm behaviour motivated by a desire to die was different from other self-harm, in terms of method used – taking an overdose – and consequences, in that the individual was less likely to feel better, and more likely to seek medical help. Such findings support the distinction between NSSI, which tends to refer to actions involving tissue damage such as self-cutting [2,6], and self-harm with suicidal intent, which is most closely associated with overdosing. However, a strong association was observed
