Deliberate Self-harm in UK Dance Students: Prevalence, Predictors, and Prevention

Self-harm, defined as an act of deliberately inflicting harm or pain upon oneself, is an alarming public health concern. Population studies have demonstrated an increase in its prevalence between the years 2000 and 2014, with 1 in 5 females between the ages of 16-24 reporting that they have self-harmed (Mcmanus et al., 2019). In clinical samples, self-harm is often comorbid with mental health conditions such as, anxiety disorders, including PTSD, substance use disorders, eating disorders and borderline personality disorder (Cipriano, Cella, & Cotrufo, 2017). Nonetheless, despite the increase in the prevalence of self-harm, there has been no subsequent increase in help-seeking behaviours, in the form of accessing professional, services by those who self-harm (Mcmanus et al., 2019). Thereby, since a significant proportion of people who self-harm do not present in mental health services, it is vital to examine the prevalence and predictors of self-harm using non-clinical samples.

Despite research highlighting the increased prevalence of related mental health problems such as eating disorders (Arcelus, Witcomb, & Mitchell, 2013) and PTSD (Thomson & Jaque, S. 2015) in dancers, no studies have investigated self-harm in this population. Thereby, this project will be the first to investigate the prevalence as well as predictors of self-harm in UK dancers. The present project will recruit 13-18-year old dancers who participate in vocational or private dance training across a variety of genres. This is particularly important as adolescents are the age group with the highest prevalence of self-harm (Cipriano et al., 2017) but do not often contact relevant healthcare services (Radez et al., 2020). By understanding self-harm in an adolescent population outside of Child and Adolescent Mental Health Services, it may be possible to help create evidence-based guidelines to aid in safeguarding young individuals more widely.

The project will employ a mixed methods design. During the first study, self-report questionnaires will be used to investigate the prevalence, demographic, protective and risk factors for self-harm in adolescent UK dancers. Furthermore, the study will examine the relationship between self-harm and eating or body concerns in dancers. The function that self-harm serves for this group and the methods used to self-harm will also be explored using quantitative methods.

During the second study, qualitative methods will be employed to gain a deeper understanding of the reasons why dancers self-harm and whether they use any dance-specific methods to do so. By using interviews or focus groups with dance students a more detailed understanding of risk and protective factors for self-harm will be obtained. Lastly, interviews and focus groups with dance teachers will explore their awareness, experiences and perceptions of self-harm as well as identify any educational or training needs they may have in supporting students who self-harm.

An important aspect of this project is the element of co-production. The third study of this project will focus on collaboratively working with dancers, dance teachers and experts on creating meaningful ways of disseminating this research. The Knowledge to Action framework (Field, Booth, Ilott, & Gerrish, 2014) will be used to guide the knowledge translation process during this stage.

An overarching aim of this PhD research will be to aid in creating safeguarding guidelines for young dancers' mental health, particularly in relation to self-harm. All findings will be formally communicated through publications in relevant scientific journals and conference presentations. Lastly, by directly collaborating with One Dance UK, following the Knowledge to Action framework, any results can be readily used to inform practice and training of dance teachers as well as enrich the Healthier Dancer Programme and the guidance offered by the National Institute of Dance Medicine and Science.