‘Self-Harm: Recovery, Advice and Support’ - helping young people

affected by self-harm through partnership work

December 1st, 2009

Today’s presentations:

1. ‘Truth Hurts’: National Inquiry into Self-harm among Young People – the need for better support.Catherine McLoughlin CBE

2. ‘Self-Harm: Recovery, Advice and Support’ – exploratory and evaluative research findings. Sarah McCoy, Research Manager, YouthNet

3. Partnership work – how a consortium approach to self-harm provision can provide greater benefits for young people.Paul Marriot – CEO, Depaul UK

4. Question & Answer session Led by Martyn Lewis CBE

‘Truth Hurts’: National Inquiry into Self-harm among Young People – the need for better support.

Catherine McLoughlin CBEChair of the National Inquiry panel

Exploratory and evaluative research

Sarah McCoyResearch Manager, YouthNet

Exploratory research• Nine depth interviews with young people who self-harm• Fourteen depth interviews with experts

Evaluative research Feedback survey

- 398 respondents (25th November 2009)- Self-selecting sample

Online discussion- Seven participants recruited through feedback survey- Private section of TheSite.org discussion boards

The research programme

Exploring self-harmChallenges• Sensitivity and ‘triggering’• Care for researcher• Aftercare • Interpretation and usage of results

Findings• Reasons for self-harm• Experience of seeking help• Recovery

Drugs Guilt Bullying

Sexual abuse RapeDepression

“The first time was a reaction to the bullying that was going on at the time, but after that it was like I would feel inexplicably depressed for no reason, and I really couldn’t feel happy, like darkness

pressing in on me and around me, and cutting kind of released the pressure somehow.

There have been many times when it was a direct reaction to something that happened. I had sex when I definitely wasn’t ready and that sparked a very bad reaction. But most of the time it was a reaction to how I was feeling in my head, because the fact that there was no reason for it made it

feel like there was really no way to stop how I was feeling except to cut.”

Louise, 16

Why self-harm?

“I think I talked to my mum first. She raided my room and took everything away that I could do any harm with. I didn’t see the point because if you want to hurt yourself you can find anything – there’s

loads of potential stuff.

Her reaction made things worse. Just the reaction. It was like maybe I should keep this stuff secret!”

Nessie, 21

DisclosureSecrecy Trust

AccessPigeon-holing and stereotypes

Intimidating environments

Negative attitudes and lack of understanding

Finding help

Barriers

Pigeon-holing and stereotypes

Intimidating environments

Negative attitudes and lack of understanding

Finding help

Barriers

“I don’t think I would have started self-harming if I had not had to wait 18 months! Self-harming was a way of communicating when something got worse, although it was not something I showed anyone. For me it became a way to acknowledge a was feeling crap.”

Maeve, 24

Access

Intimidating environments

Negative attitudes and lack of understanding

Finding help

Barriers

“There are some aspects I fit quite well with but lots of aspects I don’t fit, so this is why they are confused. There is no clear diagnosis because some of the symptoms contradict each other. They just want to put you in a box with a label – “You’ve got that. Here’s the medication to help”.

Maeve, 24

AccessPigeon-holing and stereotypes

Finding help

Barriers

Recording from focus group in Liverpool, October 2009

“I think I can better process how I’m feeling. I can simulate the questions my therapist would have asked me in my head so I can think through things. Therapy also helped me to see how out of control I was, and I have always been a kind of control freak. Control’s always been something I needed, so now if I want to [self-harm], I can think about how I don’t want to lose control of my life like that again.”

Maeve, 24

Moving forwardPositive experiences• Readily available• Non-judgemental• Highly knowledgeable

Support websites are useful• Careful moderation• Facts• Distraction strategies• Focus on general wellbeing• Aftercare and first aid

Evaluative research

Challenges• Anonymity and confidentiality• Questionnaire design• Interpretation of results

Findings• Usage of website• Experience of section• Long-term impact

TheSite.org/selfharm: Usage

• Unique visitors – 8,000+ each month since launch

• Pages viewed - 25,000+ each month since launch

• Average session duration – Approx. 3.5 minutes

• 80% of visitors from the UK

• 20+ questions asked through askTheSite each month

“The website has given me further understanding of why my friend self-harms. This will be very useful for when I talk to her in the future as it has removed my misconceptions.”

“I have made an appointment with my GP to seek help and get my self-harming habits and depression under control.”

“I will encourage my partner to ask for help for his problem.”

“Employ some of the distraction methods suggested.”

“Visit the site more often when I’m feeling down, depressed or suicidal.”

What young people think• Eight in ten (82%) found the section helpful

• Three in ten (31%) had clear intentions to take further action

• Four in ten (39%) thought their visit would help their situation

“Other sites tend to have little information, but here it looks inviting and there’re so many links to really helpful areas that other sites just don’t have. I’d say it’s the only place that really helped me stop when I had nobody else to turn to.

My first impression was positive, all the vibrant colours and the fact it just looks normal doesn’t make you feel like you shouldn’t be reading up on self-harm. Other sites tend to be plain with small writing and it puts you off a little. But here it invites you to read more and makes you feel in a way accepted.”

Female, 17

Exceeding expectations

Best bits

• Practical advice e.g. ‘What happens at A&E?

• Artwork and ‘look and feel’

• Peer to peer support

Recommendations• One size does NOT fit all

• “Don’t ask me to stop”

• Focus on promotion

• Development of key aspects of TheSite.org/selfharm

- Facilitation of experience sharing- Breaking down stereotypes- Damage minimisation- Parents and supporters

Partnership workHow a consortium approach to self-harm provision can provide greater benefits for

young people.

Paul MarriottChief Executive, Depaul UK

New media

Communicating and connecting with young people

Experience of communicating with young people who are at

a particular disadvantage

24/7 infrastructure

Provision of age appropriate advice and information on

mental health issues including self harm

Delivery of therapeutic Interventions

Youth engagement and consultation

EXPERTISE

Technical infrastructure and web functionality

Day-to-day operational work

DELIVERY

The partnersYouthNet 42nd StreetDepaul UK

Different services on the website

• Factsheets and case studies

• Video and podcasts

• Confidential Q&A service

• Public Q&A archive

• Peer support via moderated discussion boards

• Chat sessions

• Local advice finder

New media

Communicating and connecting with young people

Experience of communicating with young people who are at

a particular disadvantage

24/7 infrastructure

Provision of age appropriate advice and information on

mental health issues including self harm

Delivery of therapeutic Interventions

Youth engagement and consultation

Technical infrastructure and web functionality

Day-to-day operational work

Moderation of the self harm discussions boards

EXPERTISE

DELIVERY

YouthNet Depaul UK 42nd StreetThe partners

New media

Communicating and connecting with young people

Experience of communicating with young people who are at

a particular disadvantage

24/7 infrastructure

Provision of age appropriate advice and information on

mental health issues including self harm

Delivery of therapeutic Interventions

Youth engagement and consultation

Technical infrastructure and web functionality

Day-to-day operational work

Provision of IAG on askTheSite

Creative content created by young people

Moderation of the self harm discussions boards

EXPERTISE

DELIVERY

The partnersYouthNet Depaul UK 42nd Street

New media

Communicating and connecting with young people

Experience of communicating with young people who are at

a particular disadvantage

24/7 infrastructure

Provision of age appropriate advice and information on

mental health issues including self harm

Delivery of therapeutic Interventions

Youth engagement and consultation

Technical infrastructure and web functionality

Day-to-day operational work

Provision of IAG on askTheSite

Content created by young people

Moderation of the self harm discussions boards

EXPERTISE

DELIVERY

The partnersYouthNet Depaul UK 42nd Street

Scoping and delivery of editorial content, community and service provision,consultation with, and involvement of, young people affected by self harm,

strategic governance

How we worked togetherPartnership model

–Lead agency model–Clearly defined governance and reporting to funder–Project management culture

Creative environment–Sound relationship and shared values–Open and regular communication–Collaborative approach

Finances–Transparency based on service level agreements–Infrastructure–Implementation, promotion and sustainability

Challenges Strengths

Ensuring the service is sustainable

Investment of time

Asymmetrical partnership

Geographic spread

Shared expertise– Self harm related issues and support– Online communication– User involvement

Shared capacity– Marketing and operational– Mental health professionals and experts

Increased reach– Online and offline– Outreach and signposting– “Universal” audience

“The benefit to users is huge.

Not only could we work with a wider variety of beneficiaries to ensure we met their needs we could also provide them with a more specialised level of expertise in the subject.

We were also able to provide them with a wider range of content than before because of the elements each partner brought the project.”

Claire Easterman, Operations Director YouthNet

“Hey everyone ,My name is Jen and Im 15. Not sure what to write on here so forgive me if I am rambling a bit Anyway Im from Manchester and currently doing my GCSE's. I have mental health problems and somebody from 42ndstreet recommended joining up to the site so I did! I like to think I am friendly and approachable, I like to help people and plan on being a youth worker when I am older. Thats enough for now so I guess I will be seeing you all around”

Board user

“Hearing from your experience really helps, I mean, lots of people have tried to talk to me about it, some on other site and some just friends, but none of them seriously know what it's like and all they ever say is "Just don't cut"… As for getting rid of all my "instruments" I took care of that before I did anything. Thank you so much for your help, and I'm quite proud of myself, I haven't cut in a month…”

Board user

Benefits for the users

“This partnership has allowed us to create something that compliments our work and that

is desperately needed, but that

we would not have been able to

create independently.”

Paul MarriottChief Executive

Depaul UK

“While our staff were experienced at face to face, relational work with young peoplewho self-harm, the

partnership has given them the opportunity

and challenge of putting these

skills into practice in a new way.”

Ian TraffordHead of Operations

42nd Street

Benefits for the partners

Other benefits– New partnerships– New funding opportunities– Gain of some profile– Individuals developed new skills

and expertise

Tips for the future• A good values/culture fit• Take the time to build a strong consortium• Adopt a project management culture• Define clear roles and responsibilities for each partner involved• Mutual respect is crucial• Embrace and managing risk• Recognise collaboration costs money• Adopt a learning culture • Open and regular communication• Collaboration often starts at the top but should be operational too• Set excellence as a standard for everything you do• Never lose sight of the beneficiaries

Question & Answer session

Thank you!