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?
Discuss different methods of self-harm.

4. Almost anything can be used to self-harm.
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.
Although these methods are the most common, young people can find many different ways to self-harm.

5. Self Harm Cycle Guilt & Shame Can’t cope Cutting Crisis Moment Relief
BIG feelings
Self
Harm
Cycle
Guilt & Shame
Can’t cope
It would be useful for a discussion with an example.
Cutting
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
Bulletpoint 4 (column1): Discussion about internalising the anger so as not to physically or emotionally hurt others. This may be just their perception rather than reality, but what is important is their belief.

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

8. A calm and ‘containing’ approach is key to helping
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
Bullet point 1: It’s OK to show that you are concerned as long as you don’t appear too anxious or overwhelmed – the young person may think you can’t handle what they have to say or that they’ve made a mistake in disclosing the self-harm.

9. Have helpful attitudes and behaviours
Respect
Do not judge
Be supportive
Be calm
Listen
This is an opportunity for group discussion about how you would demonstrate these attitudes.
Emphasise being able to keep the young person involved.
A possible activity could be to discuss the barriers to disclosing self-harm and how these attitudes and behaviours may help overcome these.

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.
Discuss how telling someone to stop may not be effective, particularly if it has become an addictive pattern of behaviour. Telling them to stop the behaviour may cause it to escalate, especially if they have ever felt suicidal.
Bullet point 3: Discuss how young people will choose the person they disclose to for a reason. This may provoke anxiety but it’s important that you respect this and listen. You will follow your procedures and ask for guidance.

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
Allow for discussion around support available in your organisation and also who you might share the information with so that the young person has appropriate support.

12. Who should I ring for advice?
Child and Adolescent Mental Health Services CAMHS
For advice, signposting, referrals to community CAMHS ring
Single Point of Access Team on
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
7 days a week and available 24hr
In the event of overdose or severe injury refer to
999 or Accident & Emergency.

13. You don’t have to deal with this on your own.
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.
We need our own support networks: discuss ways of talking and getting the support you need but without betraying confidence. Respect the young person’s privacy while adhering to safeguarding procedures.

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)
MindEd is a free educational resource on children and young people's mental health for all adults including families and professionals