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The team from the University of Oxford used national data on suicide, together with data on hospital-presenting self-harm from five hospitals and data on self-harm in the community from a large-scale schools survey to estimate the relative incidence of fatal and non-fatal self-harm in 12–17 year-olds adolescents in England and described these in terms of an iceberg model including: fatal self-harm i.e. suicide, an overt but uncommon behaviour (the tip of the iceberg); self-harm that results in presentation to clinical services, especially general hospitals, which is also overt, but common; and self-harm that occurs in the community, which is common but largely hidden (the submerged part of the iceberg).