Patterns of help-seeking for mental health problems in 1001 self-identified neurodivergent adolescents who self-harm.

Background: The prevalence of self-harm is high across neurodivergence. Help-seeking is an important component of the management of mental health problems and self-harm, but it is low in adolescents who self-harm. Combined with a common neurodivergent challenge of encountering multiple barriers in accessing support, it is unclear whether and how neurodivergent adolescents who self-harm seek, receive, and perceive mental health support in comparison to their peers. Method: Participants were 12,209 adolescents (aged 11-18 years) from the OxWell 2023 Student Survey in English schools. Of these, 1001 (8.2%) self-identified as neurodivergent (dyslexic, dyspraxic, autistic, and/or have attention deficit hyperactivity disorder) and self-reported self-harm. We conducted three separate mixed-effect models to examine (1) help-seeking, (2) receipt, and (3) perceived helpfulness of the support. Results: Proportionally more adolescents who reported both self-harm and self-identified neurodivergence sought help compared to their peers who reported no self-harm and/or no neurodivergence. In line with previous studies, all adolescents were more likely to seek support from informal than formal sources and least likely to seek support online. Yet, self-identified neurodivergent adolescents who self-harm were more likely to seek formal support than their peers. When support was sought, adolescents in all groups were likely to receive it. However, those who reported either self-harm or self-identified neurodivergence were less likely to perceive the support received as helpful, especially from formal services. Conclusion: Self-identified neurodivergent adolescents who self-harm report greater unmet need for mental health support, but not due to a lack of help-seeking. These findings, instead, point to potential issues with the acceptability of support received. This highlights the need to better understand which forms and locations of support are most acceptable to meet the specific needs of this population.