SELF HARMINGPROVIDING POSITIVE SUPPORT

BackgroundHertswood Academy – 1400 students

LSA in 1992

SENCo 1994

Head of Inclusion/SENCO/DSPCP/Behaviour/Attendance 2003

Teacher

Child Protection Officer 2014

MET Child Protection Support 2014

Objectives

An understanding of self harm, who they might affect and why

Learn about the risk factors and warning signs so we can identify cases early

Share ideas for working with students, parents and external agencies

Explore practical ideas for supporting students during recovery

Changes in mental health in schools

Growing number of self-harm cases

Significant factors

Dealing with the impact

What is self-harm?Causing harm to the body, usually through physical abuse:

Cutting / swallowing tablets / burning / bruising / hair pulling / scratching / misusing alcohol or drugs

It is usually conducted at times of distress, fear, emotional worry, anger depression or low self-esteem in order to manage negative feelings

Definition

“…a deliberate act to damage yourself, without intending to die. This varies according to the situation the individual carrying out the act and is a means of getting away from intolerable thoughts or feelings”

HOTUSH

Myths

Myth: People who cut and self-harm are trying to get attention. Fact: The painful truth is that people who self-harm generally do so in secret. They aren’t trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.

Myth: Only girls self-harmFact: Not true. Both boys and girls self-harm but it does tend to be more prevalent in girls

Myth: People who self-harm want to die. Fact: Self-harmers usually do not want to die. When they self-harm, they are not trying to kill themselves—they are trying to cope with their pain. In fact, self-injury may be a way of helping themselves go on living. However, in the long-term, people who self-harm have a much higher risk of suicide, which is why it’s so important to seek help.

Myth: If the wounds aren’t bad, it’s not that serious. Fact: The severity of a person’s wounds has very little to do with how much he or she may be suffering. Don’t assume that because the wounds or injuries are minor, there’s nothing to worry about.

helpguide.org

Risk FactorsPE

RSO

NAL

ITY… Low mood /

anxiety

Difficulty communicating

Low self-esteem

Poor problem solving skills

FAM

ILY... High

expectations

Controlling

Neglect/abuse

Looked after

Young carer

Bereavement

SOCI

AL… Sexuality

confusionBullyingLack of friendsFriends with similar problemsHighly competitive hobbies

Facts and Figures1.6m people in the UK are living with an eating disorder

Up to half of young girls fear becoming fat

1 in 3 boys aged 8-12 have dieted to try and lose weight

26% of 7-18 year olds have skipped a meal to lose weight

1 in 4 teenage boys would consider plastic surgery to look more like David Beckham, Brad Pitt or Usher

1 in 10 children will have self-harmed by the age of 18

CapitaEducation

Some of the triggers

Loss of parent

helpguide.org

Serious injury or surgery during childhood

Sexual or physical abuse

Family relationship difficulties

Depression

Poor self-image and low self esteem

Poor communication skills

Loneliness

Bullying

Exam stress

Times of change i.e. primary to secondary

Warning signs

• Self-harm and suicide lie on a continuum• Not about wanting to die

Scottish Personality Disorder Unit

Mental health scale for self harm

Self Harm SuicideSocially acceptable self-harm

How do you cope as a school?

Good communication – staff need to be vigilant

Not an easy task

Time to talk with the student

Offering sound advice

Contacting parents

Sharing the responsibility

Creating an environment where young people are not frightened to disclose

Working with agencies

Strategies: Step by step advice to student

De-escalate the intensity of self harm• A first step can be to think about trying to slowly reduce the damage caused by your

self harming behaviour (e.g. cutting less or less deeply). Then try to move to less damaging practices like writing on your skin with red felt tip instead of cutting.

• Creating a personal self harm safety plan is a useful way to remind yourself of things you can do when you feel an urge to self harm. These include ways to manage and reduce self harming behaviors in the short term, so that they are less damaging, as well as alternative ways to manage difficult feelings which can replace self harm in the longer term.

Direct the harming urge at something else• Some people find squeezing an ice cube provides an alternative that is helpful. Hit

pillows or cushions. Flick an elastic band on your wrist. Take a cold bath or shower.

Small steps…Make a list of distractions• Make a list of activities that you can use to distract yourself. Trying to be with other

people is particularly effective.Know your triggers and reduce the risks• Knowing what kinds of situations are particularly risky for you can help you plan to

reduce the risks. For example, it is harder to manage your feelings effectively when you are under the influence of drugs or alcohol. Go easy on these if you are aware that you are feeling less stable.

Learn to tune in to your feelings• In the longer-term you can start to learn how to identify the experiences and feelings

which are most likely to trigger your urges to self harm. Learning the skill of ‘mindfulness’ – being tuned in to what you are feeling in the present moment, without judgement or attempt to change it – is invaluable in the move towards being able to manage or ‘ride out’ difficult feelings, rather than trying to eliminate them.

Continued…Finding constructive outlets for feelings

• Having a good cry is the natural way to get rid of built up stress hormones and get feelings out. Experiment with different ways to express feelings when they seem to be building up inside, to see what works for you. Keeping a diary can be a useful habit for getting feelings ‘out’. Just write it all down without censorship, then close it and put it away. Or it might be helpful to do something symbolic like writing it all down then scribbling it out or tearing it up. Vigorous activity or exercise can be another helpful way to get rid of pent up feelings.

Learn how to self soothe

• Make a conscious effort to take care of yourself and comfort yourself with difficult feelings. Try out different things to see what you find most comforting. Breathing and relaxation exercises can be very useful. A relaxing soak in a bubble bath, hugs or a massage, eating something sweet (in moderation), stroking a pet, listening to uplifting music, knitting or crafts… Find what works for you!

Get support and professional help

• Having people you can talk to and a good support network is a vital protection against both self harm and suicidal thinking.

• Talking about the inner feelings that fuel your self harm is potentially useful whoever you talk to, but counsellors are professionally trained to work with self harm and will be best placed to support you in finding constructive alternatives i.e. counselling, GP, CAMHS etc.

Steps you can takeTalk to other members of staff – are

they concerned?

Pass your concerns onto

the designated member of

staff

Discretely asks peers if you should

be concerned

Encourage the pupil to speak to you

How to be

helpful

Listen

Make time

Be honest

Try to understan

d

Persevere /offer support

Remember the ‘real’

child is still there

How can we encourage reluctant students to talk?

Open Questions Third Person friend / parent

Undershoot (find a chink)

Responding to Self-Harm FadsBehavioural issue

– employ usual behaviour ladder

Address the group / school- zero tolerance

Injuries to be covered

Respond dispassionately

Talk to individuals as well as group

Follow up with individuals

Self-esteem / communication / group

identity activities if specific group

Supporting Parental GP Referrals

Behaviours causing concern / Health

ramifications

Change in personality

How long this has been going on for

History of similar problems in

family / friends

Any suspected trigger

What the school has done. Impact?

What outcome you are looking for?… spell it out

Write a lett er to support GP appointment

1• Peer Support

2• Free Pass (to leave class)

3• Bolt Hole (somewhere safe to go)

4• Regular access to a trusted adult

5• Zero tolerance of teasing or bullying

Practical Strategies

A minority of parents will respond negatively when you tell them about

their child’s difficulties

What negative responses might you encounter?

Do you have an specific experience you’d like to share?

Course 7486

Difficult Parents

Who to turn to out of school?

Golden rules

Staff to be vigilant

Time to listen/talk

Contact parents

Mentor/School nurse

Provision in school JEPECA, counsellor

Refer to SPA, CAMHS, GP, Social Service

Keep in contact with parents

Attend mental health meetings with professionals

You can only do your best!

You are not a psychologist or a therapist, you are someone who cares.

If you need help ask for it!

Finally

If a self-harmer is pleased with their friends support it’s probably because

they are enabling them.

If a self-harmer is as mad as hell with you then you are probably helping them!