Canadian women are twice as likely than men to end up in the hospital for self-inflicted poisoning, burning, suffocation and cutting, based on an analysis of the Canadian Institute for Health Information’s (CIHI) 2015-2016 self-injury hospitalization data.

Women make up 62 per cent of self-injury hospitalizations, although self-injury rates in women have decreased by 4 per cent since 2010. But, women continue to outnumber men for self-injury hospitalizations in every province and territory.

Self-inflicted harm or injury means deliberately harming yourself, which may or may not result in death, according to the Canadian Institute for Health Information. Many actions, such as poisoning, drug overdoses, cutting with sharp objects, and suffocation fall under this self-injury classification. Self-injury can also be called self-harm, self-inflicting injury or even by the method of self-harm used, such as cutting.

Because self-injury is a specific personal response to an emotional, environmental, physical or cognitive problem, it is difficult to pinpoint exactly what the factors are that are causing more Canadian women to self harm, because they differ from person to person.

Stephen P. Lewis is a researcher at the University of Guelph, who studies non-suicidal self-injury, or self-injury without the intent to commit suicide. He has been open about his past struggles with self-harm, both as a teenager and young adult, and later founded SiOS, a non-profit self-injury and outreach support group.

“At its core, self-injury is a coping strategy, used by people who want or need to confront their strong emotions related to a particular problem or incident,” Lewis says.

Part of his research includes studying the connection between self-harm and social media blogging sites like Tumblr or Instagram. He believes that the biggest obstacle in self-harm recovery is that there is no “one size fits all” cause or solution, either for women or men. “Factors like the Internet or mental health, are a double-edged sword. What may aid in one person’s recovery, can end up triggering the next.”

Social attitudes towards self-harm may also contribute to self-injury rates. “Self-harm is heavily stigmatized, which means that those who need to seek help often don’t,” Lewis explains. “which could account for higher unreported injury numbers, when people are afraid or unable to reach out.”

Gundel Lake, an Ottawa-based psychotherapist that specializes in trauma and addiction, agrees that social attitudes contribute to self-injury, but believes that the imposed social attitudes create harder situations for girls than boys. She explains that the enforced gender and societal roles on women could play a role in higher self-injury numbers.

“Our society doesn’t value or support the expression of emotion, and girls and women are more often taught or encouraged to internalize emotional experience, whereas boys are taught or encouraged to externalize it,” she explains. “Emotions need to go somewhere.”

Another factor in the misrepresentation or the confusion around understanding self-harm may also be because of the data that’s used in studies. The Canadian Institute for Health Information does not specifically determine suicidal intent in self-injury hospitalizations, making it difficult to differentiate between non-suicidal self-injury versus suicide attempts. Additionally, this data is not broken down by age group, making targeted anti-self-injury groups difficult to coordinate.

Both Lake and Lewis remain hopeful that education and communication can help break the stigmatization and misconceptions shrouding self-harm and lead to higher recovery rates and lower hospitalization rates.

“It’s important to destroy misconceptions related to self-injury in order to break the stigma,” Lake says. “One thing that people can do to break the stigma is to remember that self-injury is a symptom of coping with a problem, not “the problem.”

Despite the misconceptions and double-edged swords that arise when trying to treat and understand self-injury, Lewis remains hopeful.

“Recovery is always possible. Always.” Lewis says. “A big part of it is teaching people to understand that self-injury is not manipulative or attention-seeking behaviour, but a coping strategy.”