Understanding Self-Harming Behaviors

1. Self Harming Behaviours Sue DaviesLocality Manager in CAMHSSimon HemmingsTeam Leader PMHW Service Insert Wi-Fi code

2. DEFINITION OF SELF-HARM • Self-injury is any act which involves deliberately inflicting pain and/or injury to one’s own body, but usually without suicidal intent.

3. What is self-harm? Self-harm is a way of dealing with very difficult feelings that build up inside. People deal with these feelings in various ways eg • Cutting or burning themselves • Bruising themselves • Taking an overdose of tablets etc. • Pulling hair or picking skin • Abuse of alcohol/recreational drugs • Indulging in high risk activities • Eating disorders.

4. STATISTICS • Self-harm is more common than most people realise. It is difficult to give actual figures because: • Many young people hurt themselves in secret • Many never ask for help • There is no standard definition used in research • National statistics are rare and unreliable but community based studies report higher rates than hospital based studies and they indicate that self harm is increasing with approx. 1 in 10 young people in years 10 & 11 engaging in dsh • Self-harm can affect anyone.

5. WHY SELF-HARM • Young people give a number of reasons for self-harming: • Feelings of anger, fear, guilt, shame, helplessness, self-hatred, unhappiness, depression or despair can build up over time and self=harm can be a way of dealing with this. • When emotional pressures become too much self-harming can act as a way of relieving these pressures – a feeling of relief can be gained from beta-endorphins released in the brain. • Bad feelings flow away with the blood. • The pain makes them feel alive • They are punishing themselves • It’s a way of communicating their unhappiness, although it is not generally a cry for help.

6. WHO SELF-HARMS? • Any one can self-harm but there are some high risk groups: • Young men aged between 16 and 25 • Young Asian women • Young people whose parents are professionals (eating disorders) • Young people in the care system • Young people with issues regarding their sexuality • Young people (particularly men) in the criminal justice system

7. SOME ISSUES WHICH MAY LEAD TO SELF-HARM • Issues to do with race, religion or culture. • Issues regarding sexuality • Relationship issues • Pressures to fit in • Pressures at school or work • Bullying • Bereavement • Discrimination • Poor body image • Low self-esteem • Serious/chronic illness or disability • Substance mis-use • Parental mental health or substance mis-use • Abuse • Lack of love or affection, neglect

8. HOW OFTEN? • Some young people self-harm on a regular basis. In some cases for many years. • Others self-harm just once or only on a few occasions • Some young people use self-harm as coping mechanism for a particular problem and they stop once the problem is resolved • Self-harming can become mentally addictive. • Young people may begin to harm from pre-teens to teenagehood, with many losing the urge to self-harm by their early thirties.

9. RISK • Definition: The probability that something will cause loss or harm. • All self-injury involves an element of risk. This can be to the persons’ physical health eg infection from, cutting, cutting too deep, poisoning, accidental death. • The impact to the young persons’ mental well-being continues to be impaired whilst their coping strategies remain harmful and negative

10. HOW CAN YOU HELP? Self-harm is usually a secret thing. People can feel ashamed and feel no-one will understand. If you are worried about someone who is self-harming and you want to help, you can by: • Noticing someone is self-harming • Offering to listen and support • Getting help when it is needed Someone may tell you that they are hurting themselves and ask you to keep it a secret. This can be tricky, but if you think there is a high risk it is important to get help.

11. HOW CAN YOU HELP? cont • Keep an open mind-don’t judge or jump to conclusions • Make time to listen and take them seriously • Explore/resolve underlying issues • Help them to find ways of managing their issues. Explore alternative (more appropriate ) ways of dealing with stress • Help them to work out who else can help • Offer to go with them to tell someone, or offer to tell someone for them • Carry on with the ordinary activities you do together • Support any positive steps they take • Don’t be offended if they don’t want to handle things with your help • Respect their feelings-don’t tease • DON’T tell them to stop self-harming

12. Whole School Approach • PHSE • Whole School Assemblies • School Health Services • Modelling Healthy Responses to Difficult Situations • Sharing Good Practice

13. Harm Minimisation • What is this?

14. SUPPORT FOR YOU Remember that your feelings matter too. It may be difficult to understand why someone hurts themselves. You may be shocked, angry or even guilty. • Look after yourself – make sure you get the support you need. This can be informal (talking with colleagues) or formal (team meetings, supervision, training). • Remember – even those who are trained to work with people who self-harm need support, so it’s okay for you to need support. • Try to carry on with your other activities and relationships. • You don’t have to be available for the person all the time and to the exclusion of everything else • If they hurt themselves, it is their responsibility, not yours, even if they say it is.

15. Any Questions?