Vulnerable children deliberately self-harming to stay in care, research finds

Report shines light on ‘catastrophic situation’ where young people make themselves more ill to avoid losing support

Some of the most vulnerable children and young people in care are deliberately self-harming to avoid being abandoned when they get better or turn 18 and face a “cliff edge” of no further support, according to research.

Abi Booth, a psychotherapist who works with children and young people, said some were in a “catastrophic situation” in which they were hurting themselves to keep their place in therapeutic facilities.

Booth said this group of young people believed the only way they could stay safe was not to “get better” from their mental health conditions and to become more ill by severely self-harming or attempting suicide.

A government review into the deaths of 112 care leavers in England aged 18-24 in 2025 identified a dramatic drop in support at the age of 18. The Guardian revealed in April that there had been an almost fivefold increase in children in unregulated social care settings in England.

Booth said: “Society’s system around the most vulnerable people in the UK is failing them at every level … Of the hundreds of young people I have spoken to in the course of my work in recent years, every single one has told me that the system is pushing them into patterns of risk.

“Many of these children and young people have experienced extreme neglect and often physical and sexual abuse. Some are so badly scarred from self-harming there isn’t an inch of their bodies left untouched. They see self-harming as a route to safety. They are living in a state of terror, which may be hidden underneath layers of bravado.”

Booth said that while not all children and young people in the care system fitted this description, she feared the number was growing, as indicated by the proliferation of private care units. There are 400,000 children in the social care system in England with nearly 84,000 looked after by local authorities.

Booth said that paradoxically they saw self-harm as a route to safety because while they were undesirable to financially overstretched local authorities, they were a valuable commodity to private care companies. It was only by being high-risk that they could maintain their place in the care system.

Councils often outsource these complex cases to private companies that can charge £20,000 or more per week per young person.

Booth, who has carried out in-depth research into 12 children, said that while in inpatient psychiatric units, these children and young people were “learning the tricks of the trade” in terms of more severe and sophisticated methods of self-harming and suicide attempts.

“These young people are a currency. They are more profitable the riskier they are,” Booth said. She is calling for change to better protect this group of young people without leaving them as “commodities” for the profit-driven private care companies.

“I want to shine a light on the reality of life for these young people in the hope of inspiring some change,” she said.

A report from parliament’s joint committee on human rights has found that the accommodation model in children’s social care is broken.

The report, published on Thursday, found that a lack of capacity has resulted in children being placed in expensive and wholly inadequate accommodation, often far from support networks. It calls on government to end the use of unregulated spaces as a matter of urgency.

It says measures that should be explored include increasing efforts to drive up local authority supply of placements through adequate funding, carrying out tougher inspections, and tackling delays in the registration process for homes.

The chair of the joint committee, David Alton, said: “We have a moral duty as a society to uphold the human rights of children and young people. The children’s social care system is there to be a crucial safety net to support the most vulnerable in society.

“The evidence we have heard from children in care, care leavers and experts in the field is that too often it is failing to prevent people falling through the gaps. The challenges for those in need of care do not stop when childhood ends – from the ‘cliff edge’ of support ending at the age of 18, to the increased likelihood of entering the criminal justice system, to facing discrimination once they leave care.”

The Department for Education said the government is investing £25 million to help thousands more care leavers access homes with support attached and that steps are being taken to crack down on illegal and unregistered children’s homes.

In the UK, the youth suicide charity Papyrus can be contacted on 0800 068 4141 or email pat@papyrus-uk.org , and in the UK and Ireland Samaritans can be contacted on freephone 116 123. In the US, the 988 Suicide & Crisis Lifeline is at 988 or chat for support. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org