3Attention seeking Crisis! Shame Distress Out of control Confusion Self harm!Attention seekingCrisis!ShameDistressBrain storm with groupOut of controlConfusion
4What is self harm?Self harm describes deliberate acts of hurting yourself the most common form of self-harm is cutting but self-harm also covers a wide range of behaviours including, but not limited to, burning, scratching, banging or hitting body parts, interfering with wound healing, hair-pulling and the ingestion of toxic substances or objects.
5Self Harm Myths You must enjoy it or you wouldn’t do it! People who self harm are mentally illPeople who self harm are suicidalOnly girls self harmPeople self harm because they are attention seeking
6Functions of self harm As a sense of control in ones life. As a coping strategy.As a focus/distractionAs an expression of emotional pain, stress and distress.As symptom of underlying pain.As self punishment.As a prevention of causing pain to another.(Harmless 2014)
7Suicide v Self harmSuicide is not necessarily the intention of self-harm, the relationship between self-harm and suicide is complex, as self-harming behaviour may be potentially life-threatening.There is also an increased risk of suicide in individuals who self-harm to the extent that self-harm is found in 40–60% of suicides. However, generalising self-harmers to be suicidal is, in the majority of cases, inaccurate.
8Some facts....Young suicide in the UK remains the main cause of death in young people under the age of 35.Nationwide, there were more than 22,000 admissions for self harm in the past year. Up 2,000 from the year before and up 68% in 10 years.However these figures are likely the tip of the iceberg and we don’t know how many young people are self harming.Lucie Russell- (director of campaigns-Young Minds) has blamed the increase on a ‘toxic climate’ facing youngsters. She said ‘ cyber bullying and sexting, bleak employment prospects, and a society obsessed with body image are creating a negative environment for young people’.
9Risk Factors for Young People The following groups of young people are at higher risk of self harming behaviours;Lesbian, gay, bisexual and transgendered young peopleLooked after childrenYoung people in the criminal justice systemThose who have experienced abuse, neglect, victimisation, bullying and crueltyThose who have a mental health problemThose who abuse drugs and alcoholThose who have been exposed to self harm in others
10Why is it hard to help?Teachers report that although they see the signs of young people self harming they don’t know what to say or how to reach the young person.Parents report being confused and upset by their child self harming.Self harm is traditionally associated with feelings of guilt and shame which often prevents young people from asking for help
11When is action needed? Minor Injuries – GP cuts which aren’t bleeding, scratches, hair pulling, minimal head banging, burns bigger than a 50p pieceModerate Injuries – Minor injury units, A+Ecuts which won’t stop bleeding, head banging with visible trauma, large burnsSevere Injuries – Ambulance and A+Eingestion of toxic substances or objects, large bleeding wounds, head banging with lose of consciousness, ligature attemptsIf the young person needs medical attention it should be arranged for them to go to;
12When to refer to CAMHS.....Self harm alone is not suffience for a referral to CAMHS.
13Assessing Self Harm Event leading up to Self Harm- Impulsive/ Planned Method- What did they do?Plan- Had they been researching on the internet? Did they leave a note?Intent- to die? To show someone how desperate they were?Lethality- could it have been lethal? What did they think would happen?Circumstances- were they alone? Did they go to sleep after? When did they get help?Current feelings- how are they feeling now?
15STOPP..... Stop and Step Back o Don’t act immediately. Pause. Take a Breatho Notice your breath as you breathe in and out. Observeo What am I thinking and feeling? What are the words that mymind is saying? Is this fact or opinion? Descriptions orevaluations? Accurate or inaccurate? Helpful or unhelpful?What unhelpful thinking habit am I using (e.g. mind-reading,negative filter, thinking the worst)? Where is my focus ofattention? What metaphor could I use (mountain, tunnel, playground bully, thought train, beach ball, passengers on the bus)?o Pull Back: Put in some Perspectiveo See the situation as an outside observer. What would a fly onthe wall see? Is there another way of looking at it? Whatwould someone else see and make of it? What advice would Igive to someone else? What’s ‘the helicopter view’? Whatmeaning am I giving this event for me to react in this way?How important is it right now, and will it be in 6 months? Is myreaction in proportion to the actual event? Practise what workso Do what works, what is most helpful.Play to your Principles and Values.Will it be effective and appropriate? Is it in proportion tothe event? Is it in keeping with my values and principles?What will be the consequences of my action? What is best for me and most helpful for this situation?
19Some information.MINDed- Excellent website for professionals working with young people with mental health illness. https://www.minded.org.ukYoung Minds – information for professions, parents and young people with ParentlinePapyrus- (prevention of young suicide)Hopeline (papyrus phoneline) Confidential Young Suicide Prevention Advice: HOPELineUKTESS- for girls and young women affected by self injury