Responding to Young People who Self Harm

1. Responding to Young People who Self Harm • 1 in 5 young people will self harm at least once • 1 in every 10 more than 4 times • We might panic • We may not understand it • We might not want to talk about it • It’s understandably difficulty for all of us But you can make a difference by just listening and responding

2. Self harm – a few facts • In a secondary school class of 30 up to 6 may be self harming • Self-harm can be triggered by changes in development and key life transitions, but can occur at any time. • Triggers points also include • Exam pressures from self, or from others • Issues about identity/belonging/sexuality • Friendship breakdown/bullying • Family issues • This list is not exhaustive! Any of these have the potential to cause difficulties for a young person who may use self-harm as a means to cope.

3. So what do we mean by self harm?

4. Self-harm can include cutting, burning, hair-pulling, overdose, scratching, head-banging, punching walls. • Almost anything can be used to self-harm. • Some young people will try to hide their self-harm but for others it will be more obvious.

5. BIG feelings Cutting Self Harm Cycle Guilt & Shame Can’t cope Binging Burning Starving Relief Crisis Moment

6. Reasons why people self harm Mainly it is a COPING STRATEGY a personal and private attempt at a solution to a difficult emotion, or situation. • Physical pain can seem easier to manage than emotional pain • Communication - to show that they cannot cope with painful feelings, as they are often not able to verbalise their feelings • Draws people closer- they may be afraid of being abandoned in times of great distress • Protects others from the persons intense hatred and rage • Relief from feelings such as emptiness, loneliness, sadness , anger • Ends feelings of numbness. Physical pain can remind us of our existence. • Ownership of one’s body/feel in control • May stop the person from committing an act of suicide. • Friends do it • Can become addictive

7. Life is hard and this helps me get through each day. Some people smoke, some people drink, I cut.

8. How can you help? • Stay calm • If they need medical attention take appropriate action and stay with them. • Keep talking and listening. It’s ok to let them know you recognise their distress even if you don’t understand it • It’s OK to ask questions and clarify if you’re not sure. • Try not to take it personally if you get a hostile or rejecting response. • Remember, self harm is an expression of distress and the need for support, rather than attention seeking. • Always explain what you’re going to do and follow through. • Ask them what support they have, who they can trust and who might help. A calm and ‘containing’ approach is key to helping

9. Have helpful attitudes and behaviours

10. What doesn’t help • Telling them just to stop – it’s not that easy think about addiction • Punishing them – It reinforces their negative thoughts about themselves and is more likely to increase, not stop the self harm • Removing all the risks – it’s impossible. If you take away items use to cut, something else will be found and that something is more likely to be dirty or unsafe • Expecting them to ‘take responsibility’ for keeping safe when they’re in a crisis and unable to cope – you are asking the impossible • Making assumptions about the methods and the reasons. • Telling them that you’re not the person to talk to and passing them on to someone else.

11. Follow your service guideline • This will usually mean contacting the Welfare or Safeguarding lead for your school/practice/club • Make sure you know what your organisation’s self-harm and safeguarding policy is and how to access it • Keep a record of what happened and what was said and, if applicable, notify the safeguarding system • Do what you have promised to do • Tell the individual if you’re going to speak to someone or do something. • Ensure you follow up with the young person • Consider the support networks that are available to the young person eg. school, GP, One Point, school nurse

12. Who should I ring for advice? Child and Adolescent Mental Health Services CAMHS • For advice, signposting, referrals to community CAMHSring • Single Point of Access Team on 0300 123 9296 • Monday to Friday 9am – 7pm • In an emergency or if you need urgent advice, suicidal thoughts, extreme or low mood or unmanageable distress • Crisis & Liaison Team 0191 441 5733 • 7 days a week and available 24hr In the event of overdose or severe injury refer to 999 or Accident & Emergency.

13. How do I cope ? • This can have a big impact on us • It normal to be distressed and worried but recognise and contain it at the time then later ask for help. • Accept that this can be scary and we need our own support networks – talk to someone about your thoughts • Learn more about self harm – in particular understand this young person’s self harm – remember it’s ok to ask! • If in doubt seek advice from the CAMHS team. Support is vital You don’t have to deal with this on your own.

14. Further guidelines and resources Self-harm Guidance for schools for County Durham Self-harm Guidance for professionals working with children and young people (County Durham Version) Self-harm Guidance for professionals working with children and young people (Darlington Version) https://www.minded.org.uk MindEd is a free educational resource on children and young people's mental health for all adults including families and professionals https://youngminds.org.uk/