Tackling self-harm: Further resources and advice

Written by: Karen Sullivan | Published:
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Given the alarming statistics on self-harm, Karen Sullivan suggests some approaches schools might adopt to raise awareness and help tackle the problem

In my last article, we looked at the distressing increase in self-harm in adolescents, and the ensuing associated problems, including depression, sleep problems, psychological distress and suicide risk (Making time to stop self-harm, SecEd, September 2017: http://bit.ly/2xlYgJe).

We also learned that educational settings play a critical role in promoting wellbeing in young people, and that PSHE lessons, in particular, could provide a means of tackling this growing problem.

So what should that include? First of all, it is important to identify some of the reasons why young people self-harm; by recognising their own triggers or situation, self-harmers can take the first step towards accepting that there is a valid reason for their behaviours, and get help for the root cause.

The Samaritans tell us: “Some people harm themselves because they don’t know how else to cope with pressures from family, school and peer groups. Extreme feelings such as fear, anger, guilt, shame, helplessness, self-hatred, unhappiness and depression can build up over time. When these feelings become unbearable, self-harm can be a way of dealing with them.”

They also outline reasons young people have given for their self-harm, such as “cutting makes the blood take away the bad feelings”, “pain can make you feel more alive when feeling numb or dead inside”, and “punishing yourself in response to feelings of shame or guilt”. Perhaps most poignantly, harmers often react “when it’s too difficult to talk to anyone, it’s a form of communication about unhappiness and a way of acknowledging the need for help”.

All students need to understand that they are in a supportive environment at school, no matter what goes on outside its doors. It goes without saying that steps to eradicate bullying, peer pressure, academic pressure and stress, and abuse on any level from the school environment is an essential part of this.

All schools should have an arrangement for confidential help or guidance, for self-harmers or for those who suspect that someone is self-harming. Whether this is a head of year, a form tutor, a school psychologist, or head of pastoral care, this type of support needs to be in place and it needs to be widely advertised.

While it would go beyond the remit of most school staff to solve these problems, this type of support will go a long way towards helping sufferers feel more secure and less alone – it will help them feel heard. All staff should be able to provide guidance for where sufferers can seek clinical help.

Equally, everyone in the school community should understand what self-harm is, the serious potential dangers, and how to recognise it.

According to the NHS, some of the most common signs of self-harm include: “Unexplained cuts, bruises or cigarette burns, usually on the wrists, arms, thighs and chest; keeping fully covered at all times, even in hot weather; signs of depression, such as low mood, tearfulness or lack of motivation or interest in anything; self-loathing and expressing a wish to self-punish; not wanting to go on and wishing to end it all; becoming withdrawn and not speaking to others.”

Without wishing to frighten those who are caught in the self-harm trap, it is important to point out the side-effects; this can also work to deter those who are considering using it as a coping mechanism (sound research suggests that young people who have friends who intentionally harm themselves are more likely to begin self-harming).

Possible complications include: serious infections (most cutting takes place in secret, wounds go untreated and implements unsterilised), tetanus, gangrene, permanent scarring, HIV, some types of hepatitis, severe and possibly fatal injuries when taken too far.

As we discussed in my last article, self-harming can be addictive, and clinical help will be required to break the cycle. However, in the short term, schools can help in a variety of ways. For example, help students to identify and/or create their own personal support network – friends, family, teachers, etc – who can provide a listening ear and help deter harm when problems are experienced. They should also know that there is help outside the school doors, such as the Samaritans or Childline.

Equally, all students need to learn strategies for coping with emotional pain and stress, something that can be undertaken in PSHE lessons or within the tutor group. For example, understanding that intense emotions are normal, and being able to name, accept and express feelings instead of internalising them or using self-harm to “release” them. Some experts suggest that writing or drawing the feeling, and then shredding the piece of paper and discarding it, can be useful to provide a sense of release.

Similarly, emphasising the importance of good physical health – diet, sleep, exercise and relaxation, all of which underpin emotional health – can help students to look after themselves better and learn to value themselves and their overall health.

There is a multitude of resources outlining strategies that can be useful for individual students (some are listed below). One important measure can be to create a personal stress management plan.

Ultimately, no child should feel helpless or unsupported, and with excellent research (see last article) showing that PSHE is the ideal place in which to encourage a sense of belonging and a support network that can help to prevent self-harm and discourage it from escalating, all schools should consider incorporating this into the curriculum in whatever way possible. It’s a problem that is on the increase, with serious repercussions, but we have the potential and the means to prevent it, if we take steps now.

  • Karen Sullivan is a best-selling author, psychologist and childcare expert. Email kesullivan@aol.com. To read her previous articles for SecEd, including in this series, go to http://bit.ly/1SNgg00

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