1. MANAGING SELF-HARM By Teresa Overall

2. Self-Harm Statistics 29% of young people in Plymouth aged 16-25 have self harmed, that’s 1in 4. Rates of Self Harm in the South West are the second highest in the country. Rates of Self Harm have increased in the UK over the past decade and are now amongst the highest in Europe It is more common in females than males, although self harm amongst males is increasing Rates of Self Harm admissions in Plymouth, Devon and Cornwall are significantly worse than the national average.

3. Self-Harm Statistics People who self harm are 100% more likely to commit suicide. One half of the 4000 suicide deaths a year will have self harmed at some point in their lives. People who self-harm are 100 times more likely to commit suicide than the ‘general population’ Self poisoning with prescription and non prescription drugs is by far the most common form of self harm when attending A+E( 80% poisoning 15% cutting). Health service staff frequently have a negative attitude to self harm, especially those who harm repeatedly

4. How to Respond to Someone who Self Harms Establish a safe space Be Patient, it maybe difficult for them Be Non-Judgemental Give reassurance Do try not overreact to what they tell you, or to what they may of done. Try to deal with the person with Warmth and Empathy Try to see the Self Harmer as a person and not just as someone who Self Harms

5. Good Practice Try to be Knowledgeable about what is available in terms of support, i.e. groups, courses and Therapy Be person centred, work with someone and not for them. Be as consistent as possible, don’t stop caring just because someone harms themselves regularly. Don’t hold past experiences against someone and don’t make assumptions. Ensure communication between services and the client

6. Good practice 2 Try and be Human, if you can give a little of yourself Know your limits- of your experience and knowledge Never assume someone will want to talk about their self- harm Try not cancel appointments at short notice as this can cause anxiety for the person Don’t say you know and understand if you don’t Give as much support as you can

7. Good Practice 3 Don’t make promises you can’t keep Don’t say that you will do something and then not follow it through. Don’t ask a person who self harms to make promises about their Self Harm Don’t suddenly stop your support Try not to let the Self Harmer down

8. Distraction Techniques Go for a walk/Ride/Drive Paint or draw a picture Play with or stroke a pet Bake a cake Write a poem/write in a diary Do a physical activity ie swimming Go to the Zoo/animal sanctuary Watch a film/tv Listen to music

9. Longer Term Distractions/Coping Strategies HALT-try never to be Hungry, Angry, Lonely or Tired Try not to be alone when the Urge hits, go to a friends or public places If you can’t throw away SH materials make them inaccessible Write a list of people you can call when the urge hits Make a rule i.e. I will not SH at work

10. Longer Term Distractions/Coping Strategies 2 Make a list of crisis lines with numbers and times they are open Try simple achievable goals-try making a day a ‘I will not SH day’ Avoid temptation- avoid aisles where blades are kept, buy only small packets of over the counter meds Make an urge card, which is a small card that fits in a wallet. List healthy coping strategies that work for you, reasons not to SH, positive statements about yourself, whatever helps you most.

11. Stopping Self-Harm The person who self harms must want to stop Positive distractions Not replacing one addiction for another No pressure, No promises unless from the self harmer Plenty of support to help them to stop and to stay away from Self Harm Support and strategies to help in times of Crisis 5- minute rule or if they can manage it 15 minute rule Boredom- structure in their day is important to help them to stay away from Self Harm

12. Stopping Self-Harm 2 Regular therapy or counselling Check-up's to oversee injuries Access to medications that may help with disorders associated with self-harm i.e. Borderline Personality Disorder, Depression Stay’s in Hospital if feeling ‘unsafe’ or self destructive if helpful A source of information and someone to talk to Some people will not want to stop Self-Harm and this must not be seen as bad- ultimately it is a coping strategy