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(Mental Health Foundation, 2006)

(Mental Health Foundation, 2006). The phrase ‘self harm’ is used to describe a range of things that people do to themselves in a deliberate and usually hidden way. It can involve: Cutting Burning Scalding Banging or scratching one’s own body Breaking bones Hair pulling

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(Mental Health Foundation, 2006)

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  1. (Mental Health Foundation, 2006) The phrase ‘self harm’ is used to describe a range of things that people do to themselves in a deliberate and usually hidden way. It can involve: Cutting Burning Scalding Banging or scratching one’s own body Breaking bones Hair pulling Swallowing poisonous substances or objects Self harm / Injury “Self-injury is any act which involves deliberately inflicting pain and/or injury to one’s own body, but without suicidal intent” (Basement Project, 1996)

  2. What is Suicide? “Suicide is the act of a person consciously (willingly) ending their own life” (Samaritans, 2007)

  3. Reasons cited for self-harm by young people consulted for the inquiry - being bullied at school - not getting on with parents - stress and worry around academic performance and examinations - parental divorce - bereavement - unwanted pregnancy - experience of abuse in earlier childhood (whether sexual, physical, and/or emotional) - difficulties associated with sexuality - problems to do with race, culture or religion - low self-esteem - feelings of being rejected in their lives (Mental Health Foundation, 2006)

  4. Reasons for self-injury: Feelings Precipitating Emotional Pain (sadness, grief, hopelessness, desperation) 57% Self-hatred (shame, guilt, ‘dirtiness’) 51% Anger (frustration, powerlessness) 50% Anxiety (fear, tension, panic) 34% Neediness (unsupported, unheard) 30% Unreality (numbness, deadness) 9% Reasons for self-injury: Functions Served Relief of feelings (expressing, externalising, distracting, numbing, calming) 57% Self-punishment (atonement, washing / cutting out ‘badness’ or ‘dirtiness’) 37% Control (over own life / self, own anger, make unattractive to abuser) 33% Communication (to self or others, feelings or problems) 15% Comfort / nurture (by self or others) 13% Feel real or alive 6% Stop flashbacks 3% (Source:Arnold L Women and Self injury: A Survey of 76 Women, BCSW, 1995)

  5. SUICIDE???? There is no one reason why people take their own lives. It is often as a result of problems building up to the point where the person can see no other way to cope with what they’re experiencing. Suicide risk is greater where there is:- - Recent loss or the break up of a close relationship - An actual or expected unhappy change in circumstances - Painful and / or disabling physical illness - Heavy use of, or dependency on alcohol / other drugs - History of earlier suicide attempts or self harming - History of suicide in the family - Depression (Samaritans, 2007)

  6. “Self-harm isn’t necessarily about suicide. Sometimes people harm themselves because they want to die. But often it’s more about staying alive. People may hurt themselves to help them get through a bad time. It’s a way to cope” (The Basement Project, 2000)

  7. Self-Harm: The Facts FACT - Self-harm isn’t necessarily about suicide FACT - Self-harm is often a way of coping FACT - Lots of people self-harm FACT - People self-harm in many different ways FACT - It can happen just once, or many times FACT - It doesn’t mean you’re off your head FACT - It’s not just ‘attention-seeking’ FACT - People can and do stop self-harming (The Basement Project)

  8. How Can I Help? • Acknowledge and respect young person’s distress • Be supportive, calm and practical • Listen respectfully – people who self harm are experts of their own situation • Treat person with dignity and respect their right to confidentially and privacy

  9. What not to do….. Don’t: • Take it personally • Force things – trust takes time • Issue ultimatums • Tell young person off or punish • Jump in with assumptions • Avoid talking about it • Try to force them to stop or ask them to promise to stop self harming • Panic or overreact

  10. SUGGESTIONS & IDEAS • Harm minimisation – reduce the risks without removing coping strategies (first aid kit/ ground rules • Work with the young person/ social worker/ other to create a safety plan (plan/ record/ communicate) • Help the young person to try out ‘safe’ alternatives to express their feelings/ needs – don’t force them though • Identify sources of support for young person AND you, particularly in a crisis • Child protection?! – work within LA procedures & guidelines (discuss with relevant professionals) • Consider needs of all young people in residence • Empower & enable

  11. T ell A sk L isten K eep safe (ASIST) DON’T BE AFRAID TO ASK THE QUESTION - be sensitive and appropriate – let’s try it out! • d

  12. Issues & challenges for workers: Feelings: • Shock, horror and disgust • Incomprehension • Fear and anxiety • Distress and sadness • Anger and frustration • Powerless and inadequacy “It is natural and understandable for someone working with people who self-injure to struggle with feelings discussed above. What needs to be considered is how these feelings may impact on our work. Sometimes the stress & difficulties of dealing with self injury can lead us to work in ways which are not very helpful. This is particularly so if we do not have sufficient support and supervision for our work” (Basement Project, 2005)

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