FOR Jane Atkinson, self-harm has become a ritual. She lays out a towel on the table, sits down and rolls up her sleeves. She takes out her pen knife, wipes the blade and begins cutting into her arms.

"At the time, it doesn't really hurt. You see the blood running down your arm and it's like watching somebody else do it but it kills afterwards. I know some people who burn themselves with cigarettes or matches but it's always cutting with me," she says.

Jane (not her real name) is a self-harmer, one of thousands of young people, mainly women, who inflict injuries on themselves. Her arms are criss-crossed with a network of scars. The puckered, white skin attracts curious stares and occasionally looks of revulsion, and she's learned to hide it with long sleeves.

"People think you're a freak or a psycho and it's not like that. It's an illness but because it's mental, they don't want to know about it. If you had cancer or leukaemia you would get a totally different reaction from people. They are ignorant about it and I think they're frightened because they can't get their head round it. There is definitely a stigma about it."

Rates of self-harm in the UK have increased over the past decade, making them the highest in Europe. At present, one in ten teenagers deliberately hurts themselves, and more than 24,000 are admitted to hospital each year.

Britain's first inquiry into self-harm among 11-25 year olds was launched last month. Run jointly by the Mental Health Foundation and the Camelot Foundation, it comes in response to growing concern about self-harm among young people.

The subject is not fully understood and until recently, very little research had been carried out into its motivations or treatment. The inquiry is calling for young people, parents, carers and health professionals to come forward and share their experiences. Its aims include education and raising awareness and providing training and practice guidelines for individuals and organisations who work with young people who self-harm.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, says: "This is something that really needs to be looked into because we don't know how widespread it is and we don't really know what's going on in mental health terms. The increase in self-harm shows that something is wrong. It may be that young people are facing growing problems or that we are unable to respond to these problems.

"We're hoping to have the inquiry finished in 18 months and we will then have an idea how much this is happening, where it's happening and what can be done to prevent it. That will form the basis of future policy recommendations."

The most common method of self-harm is repeatedly cutting the skin but the condition also encompasses burning, scalding, hitting or scratching and swallowing small amounts of toxic substances to cause discomfort and damage.

THE average age for children starting to self-harm is 13, but those as young as seven have been found to do it. Some groups of people are more susceptible, including young female prisoners and Asian women.

Women self-harmers outnumber men seven to one. The reason for this is not fully understood, although it is thought that women are more likely to express anger against themselves. However, rates among young men and boys have almost doubled since the 1980s.

People normally self-harm as a result of profound emotional pain. Self-harming can help to release feelings of self-hatred or anger. The onset of self-harming behaviour has been linked to problems in a young person's life such as being bullied at school, not getting on with parents, parental divorce, abuse, rape or bereavement.

There are many myths surrounding self-harm and treatment is often based on inaccurate stereotypes. Many self-harmers say they have received unsympathetic treatment from medical professionals.

Dr McCulloch says: "They're often dismissed because there's an attitude that they're seeking attention but a lot of people do it in private. They're trying to release their emotional pain and distress and this is something we need to get across."

Although there is a close relationship between suicide and self-harm, the two are different. Self-harm may, in fact, be a means of getting through a suicidal period, and although it seems extreme to others, may represent self-restraint.

Jane, who lives in Sunderland, started to self-harm when she was 14, following her parents' divorce. She says: "I felt out of control and on my own and I just found myself doing it. I didn't do much. It was more like scratching the skin. There were red lines but there wasn't any blood. Then I started to do it more and it did bleed.

"Self-harm takes over your life. It's hard to explain but it helped me. I felt I was in control and I was doing it three or four times a week. It was a way of getting through.

"It was quite a long time before anyone found it because I did it on my own. People say it's a cry for help but it isn't. I wasn't pretending I was going to commit suicide. I thought about it sometimes but I never really wanted to."

Her GP prescribed medication for depression and she was referred to a counsellor but it didn't help. She found herself overwhelmed by feelings of hopelessness, stopped going out with friends and didn't bother with her appearance. Her schoolwork suffered and she failed three GCSEs. She says it was her lowest ebb.

"My parents kept trying to help me. I didn't really want to but they got me to do my re-sits and I went into the sixth form. I was still self-harming but more people knew about it. My friends were really good but I found a website where you could talk with other self-harm people in chatrooms and that was the best thing.

'YOU'RE talking to people who know what you're going through. Everyone is different but they all have the same sort of experiences. I made a lot of friends there. I haven't met any of them but we chat and if someone's going through a bad time you give them your phone number. It's brilliant - much better than any of the counselling I had."

Scrolling through one of the message boards reveals a disturbing world: a 13-year-old who has started cutting herself asking for advice; a woman who returned to self-harm after her marriage broke up and another asking for medical advice after burning herself with chemicals. It's hard to read without being moved but as an outsider, it's difficult to understand the complex emotional issues involved. What does come across, however, is the strong sense of camaraderie that helped Jane so much.

Although she still self-harms occasionally, the 20-year-old is learning to control her condition. She is studying English at Manchester University and says she feels happier than she has for a long time.

"I'm now at university and I'm doing OK. I haven't self-harmed properly for nearly two years but sometimes I do it when things get hard. I try not to because I know what it could be like if I went back to the way I was.I know it's a bad thing."

* The National Inquiry into Self-harm, www.selfharmuk.org.uk. If you need help, contact the Self-Harm Alliance on (01242) 578820 or visit www.selfharmalliance.org