Help a self harmer

Do people recover from self-harm?

The vast majority of young people will in time learn different ways of coping or find they no longer feel the need to harm. A very small group will continue on into adulthood, and it is likely that for them there are some deeper underlying mental health issues which need to be addressed.

In terms of child development, adolescence is when a young person develops the coping skills to deal with situations they face and the emotions they generate. Engaging with this process is key to overcoming self harm, and if a young person relies on harming throughout their adolescence they will not have the opportunity to develop these skills; skills which are virtually impossible to learn outside of this developmental window.

Do I need to tell the school?

What is expected will vary from school to school. Different schools have different policies, some will expect a full disclosure and treat it as a child protection case, others will inform parents and others will not expect to be told unless the child is thought to be at risk of taking their own life. When working in schools it is key to know how each school likes to work and how they expect you to engage with their policy.

Should the parents be informed?

This is a difficult one and the answer partly depends on the age of the young person.

Young people are often adamant that they do not want their parents to know for fear of how they will react. However, professionally it is a lot safer for parents to know something of the troubles their child is facing. Some services for self-harm cannot be accessed by young people without parental consent.

It is important to remember that parents often react badly to the news of a child self-harming, they feel panic and shock, fear that people will think it is their fault and anxiety that their child has not come to them earlier. Many people know very little about self-harm and fearful of what they don’t understand. It is important to prepare the young person for this, so they understand where any reactions may be coming from.

What help is available for young people who self-harm?

This really varies from area to area. Any young person who self-harms and is struggling emotionally will be eligible for a Child and Adolescent Mental Health (CAMH’s) referral; The referral process is tightly controlled andcan normally only be made either by a school SENCO (Special Educational Needs Co-ordinator) of the school or by a GP. The waiting list for this can be long and may not be appropriate for each young person. If you have concerns about the wider mental health of a young person it is good to encourage then to see their GP who can make a more informed assessment of the situation. There are an increasing amount of services that are specifically for those who self harm, for example in Luton, LCET runs psycho-educational and psycho-therapeutic groups specifically for those who self-harm.

What is harm minimisation?

Harm Minimisation is a term most commonly associated with drug users, where it is acknowledged that alongside the taking of any drugs there are other risks that can be avoided, like those of using dirty needles. The NHS has schemes of needle exchange meaning those who would be using anyway can use in the safest way possible.

In terms of self-harm, the focus on harm minimisation is on reducing the physical risks of the harming. These include using new sharp blades, which reduce the risk of infection and give a clean cut which will heal more quickly; using good first aid practice; and harming in ways that require less surgical intervention – e.g. cutting vertically up the arm rather that horizontally across the arm.

“I have two self-harmers that I work with, can I work with them together?”

Yes, absolutely, it’s commonly assumed that putting self-harmers together will turn into a tip sharing competition that sees little benefit for those involved. However the reality is it can give a safe environment to discuss the issues and responses of others who can empathise, taking the sting out of the feeling that many harmers have that they are the only ones to feel like this. In fact peer group work, especially in schools, has been long thought of as the most effective intervention for young people who self-harm.

Resources

On the web

www.selfharmuk.org
Information about ‘Truth Hurts’, the report of the National Inquiry into Self-harm, 2007

http://www.selfharm-uk.org
Basic information about harming, including how to support self harmers and advice for parents.

www.siari.co.uk
Helpful information from one of the UK’s established experts on self harm.

In the coming months a new Christian based resource, selfharm.co.uk, will be launched to meet the needs of young people who self harm. It will be a key source for resources, information and ideas for dealing with self-harm and related issues.

In print

“Self Harm: The Pathway to Recovery” by Dr Kate Middleton and Sara Garvie
A very practical guide to supporting someone who is self-harming, useful for youth workers, parents and harmers alike.

Training

Quality Training (www.qualitytraininguk.com) offer regular two day courses about young people who self injure.

Feel free to use and distribute this guide but please acknowledge schoolswork.co.uk as the source.