Care System Failures May Drive Vulnerable Young People to Self-Harm

Some highly vulnerable children and young people in England are reportedly harming themselves deliberately because they fear that recovering—or reaching adulthood—will cause the care system to withdraw its protection, according to research by psychotherapist Abi Booth. Booth said she had carried out in-depth research involving 12 children and had spoken with hundreds of young people during her work in recent years. She described a situation in which some believe they must remain seriously unwell, or become more high-risk, to keep their place in therapeutic care. The young people discussed in the research had often experienced severe neglect and, in some cases, physical or sexual abuse, Booth said. She reported that some had learned more severe methods of self-harm and suicide attempts while receiving inpatient psychiatric treatment. She also said the pattern did not describe every child in care, but feared it was becoming more common. Booth attributed part of the problem to the way complex cases are handled by financially pressured local authorities. Councils frequently outsource care to private providers, which can charge £20,000 or more per week for an individual young person. Booth said this created a harmful contradiction: children who were difficult to place could become financially valuable to private companies, while the young people themselves came to view being at greater risk as a way to remain safe. The concerns coincide with broader warnings about gaps in England’s care system. A government review into the deaths of 112 care leavers aged 18 to 24 in 2025 identified a sharp reduction in support when young people reached 18. Separately, a report from Parliament’s Joint Committee on Human Rights said children were being placed in expensive and inadequate accommodation, sometimes far from their support networks, because of insufficient capacity. The committee called for urgent action to end the use of unregulated spaces, improve local authority placement capacity, strengthen inspections and reduce delays in registering children’s homes. Its chair, David Alton, said children were too often falling through gaps in a system intended to protect them. The Department for Education said the government was investing £25 million to help more care leavers obtain homes with support attached and was taking steps against illegal and unregistered children’s homes. Anyone in the UK concerned about suicide or self-harm can contact Papyrus on 0800 068 4141 or the Samaritans on 116 123. In the US, the 988 Suicide & Crisis Lifeline is available by phone or chat.