1. No Secrets Supporting those affected by self-injury Self-injury awareness: No Secrets – history and progress Self-injury (inc. NICE guidance) My personal story (Kerri Jones)

2. WARM UP Exercise 1

3. Why No Secrets started... Co-founded Oct 2007 – 2 volunteers Lack of support Alone – me and family Lack of understanding Nobody spoke about it No Secrets – how we want it

4. Our Mission To provide a safe and supportive environment for anybody affected by self-injury To raise awareness of self-injury To tackle stigma associated with self-injury We aim to achieve the above by providing peer support, providing awareness-level training, running awareness campaigns, communicating with as many as possible and working closely with local health services.

5. Since October 2007... Group 1 St Helens continuing to run Group 2 Wigan started early 2011 Group 3 Halton launched May 2011 Group 4 Family/friend support – 20 th July @ PB Continual awareness level training to over 200 people Local press, Saints (RLFC), Pick Me Up, BBC News Now have 10 volunteers Successful activities/fundraisers

6. Sponsored Abseil – St Helens

7. Sponsored mountain climb

8. Donut men – Wigan group 2011

9. No Secrets in one sentence... A feeling of belonging and that Im not alone Means I can make a difference to other peoples lives Support and guidance, and friends when you need it most People understand self-harm, and me No Secrets is a fantastic place to open up and meet new friends A safe place just to be I belong! People committed to improving lives

10. No Secrets in one word... Friendly Helpful Reliable Super Hope From Wigan & St Helens group members in, April 2011 Happy Inspirational Accepted Friendship Peace

11. Self-injury Definition adopted by NICE: intentional self-poisoning or injury, irrespective of the apparent purpose of the act. Not always connected to suicide. Majority preventing suicide. 2 categories: Self-injury and self-poisoning.

12. Self-injury/self-poisoning SI - Cutting, swallowing objects, insertion of foreign objects into body, burning, stabbing. SP – overdosing with medicines, swallowing poisonous substance. Self-injury more common than self-poisoning, this is not reflected in statistics. People who self-poison are more likely to seek professional help.

13. NICE: Clinical need for guidance 150,000 presentations to A&E each year UK rates are amongst highest in Europe Half of the 4000 people who die each year by suicide will have self harmed at some point Self-poisoning most commonly seen in EDs Cutting most common form of SI 100x more likely than general population to die by suicide, whether intentional or accidental Information from Clinical guideline 16

14. NICE: Key priorities for implementation Respect, understanding and choice Staff training Activated charcoal Triage Treatment Assessment of needs and risk Psychological, psychosocial and pharmacological interventions Information from Clinical guideline 16

15. Risk factors & life events Single Divorced Live alone Single parent Severe lack social support Disadvantaged background Victimisation (domestic abuse, sexual abuse etc) Alcohol/drug use Information from Clinical guideline 16

16. Psychological characteristics Certain characteristics more common in SH: Impulsivity Hopelessness Poor problem solving Nearly ½ those presenting to EDs with SI meet criteria for having a PD (though this can bring its own problems)

17. How many self-inflicted injuries did Warrington A&E treat within the space of 9 months (1 st April- 31 st Dec) in 2010

18. What percentage of that 802 were male?

19. What was the average age of all 802 people who presented to Warrington A&E?

20. WHY DO WE SELF HARM? Relieves tension Punishment Calming/self soothing Focus shifts from emotional to physical Control Adrenaline rush Numbness/detached - It makes me feel alive Anger and self-hatred Depression jeckle and hyde effect Very upset Problems can seem smaller afterwards Anxiety

21. IF ONLY YOU COULD GET IT! Self harm makes me feel something when I feel numb I dont do it for attention Im hurting myself, nobody else Its mostly easier not to tell anyone Ive done it A bigger wound doesnt mean worse feelings We can have accidents too

22. It helped when… The professionals working with me werent scared of talking about self harm. My support worker expressed they wanted to understand as much as possible Somebody accepted that self-injury is my way of coping for the time being I was told to be safe rather than told not to do it People truly believed I didnt want to keep hurting myself, even though it didnt come across that way I was offered support after telling somebody about my self harm, rather than being told I was seeking attention and being manipulative.

23. It really didnt help me when: People said I was being stupid or I should have known better Staff got annoyed with me after Id harmed, for not talking about it before I did it A&E staff refused me pain relief Someone took all my sharps away (where no suicidal intent present) I heard people laughing at me Staff said they were disappointed in me I was reminded of those who I love and told how much I was letting them down People made a big deal of it when they didnt need to

24. In summary DODONT Talk about SH and ask if you are unsure Ridicule/put me down Understand as much as possible and reflect on your actions Blurt out responses AcceptTreat differently from everyone else Be SafeRemove my only coping mechanism Believe & encourageLaugh/make fun of Non-judgmental supportFocus on negatives of SH Generally, focusing solely on negatives to self-injury will make person feel worse. Try to explore a variety of potential positives and negatives (Sharon)

25. My story Abused in early childhood Uni, deaths (april – Aug), cutting and suicide attempts 2005-2006 - SIPU 2007 Started voluntary work and co-founded No Secrets with mum Extent of abuse accidentally revealed to family Reported abuse to police Self-injury – as long as remember. My release from overwhelming feelings of sadness, self- hatred and anger.

26. What Ive learned since initial breakdown Honesty is vital Acceptance important Actively work on tackling problems Help others with similar issues Im not alone Ive achieved more than I thought capable Anchors – family, friends, pets

27. Open Q&A This is your chance to ask any questions around self-injury and/or mental health problems We will always be honest and do not worry that any questions will act as a trigger We want you to be honest Bring up anything you may want to discuss within the group Your questions help us to see how it is from your perspectives

28. Feedback and check out Share with the group what you have learned from this session Its important that we remember that anybody can be affected by self-injury. If you have been affected by this session try to speak to somebody before you leave Check-out... What are you going to do this evening?

29. Evaluation We would be grateful if you could complete the evaluation form for us to feedback your own thoughts on how this session went This will help us to improve and continue the work we are doing

30. Thanks! More details can be found on our website: http://nosecrets.moonfruit.com http://nosecrets.moonfruit.com For more information on the WIGAN group, contact Kerri on 07846 889 300 or email kerri86@gmail.com kerri86@gmail.com For more information on the ST HELENS or HALTON groups contact Tina on 07863 736 647 or email tina.sthelens@gmail.comtina.sthelens@gmail.com Thank you for your support!