1. What’s the Harm? Self Harm Awareness & Skills Allison Murray Glasgow (South) Community Health Partnership

2. Responding to Self Harm in Scotland, Final Report : Scottish Government March 2011 ‘Self poisoning or self injury, irrespective of the purpose of the act’ ‘Cumulative research evidence from the UK suggests that the majority of acts of self harm are not intended to end a person’s life (therefore not suicide attempts). Attempted suicide is included within the scope of the adopted definition’

3. What’s The Harm? Deliberate self harm is an act which is intended to cause injury to ones-self but which is not intended to result in death. It is often described by those who self harm as a way of coping with emotional pain and of surviving distressing experiences. It is not a suicide attempt.

4. Background 2006 Self harm training need identified (Choose Life, Renfrewshire) Provision of suicide prevention & self harm intervention service 2006 1 st training day created 20071 st T4T created 2007-11 Delivered sporadically – recognition that capacity an issue

5. Recent Developments 2012-14 NHSGG&C wide working group, partners across sectors/services/communities including: University of the West of Scotland Inverclyde CHCP West Dunbartonshire CHCP Glasgow City CHP (South) Renfrewshire Council Renfrewshire Association for Mental Health People with lived experience

6. Aims To increase awareness and understanding of self harm as a coping strategy & a response to distress To reduce barriers to appropriate and safe interventions To reduce stigma and dispel myths associated with self harm To link with work being developed by existing networks of interest e.g. Shared Strengths and community based forums/networks To ensure that the learning outcomes match effectively with the various sector requirements and are in line with standards expected in context of professional development

7. At the same time….. Responding to Self Harm – Scottish Government 2011 2013 Engagement Process 2013 - 2016 Scottish Government: Suicide Prevention Strategy

8. Response to distress It is a response to distress. It can be a way of coping with unbearable emotional pain, feelings of powerlessness and hopelessness. These feelings may arise from events happening in a persons life right now or painful experiences in the past that left the person feeling powerless, bad about themselves, alone, hurt and betrayed.

9. Function of self harm Demonstration of feelings when unable to talk about them Expression of anger Distraction from emotional pain Expression of guilt, shame, self hatred Gaining control Relieving a sense of numbness Regulation of feelings Permission to nurture (post self harm)

10. What is harm minimisation? ‘it is about accepting the need to self harm as a valid method of survival until survival is possible by other means.’ (Harm Minimisation: limiting the damage of self injury by Louise Roxanne Pembroke, founding member of NSHN) Does not encourage self harm, it is about the reality of maximising safety in the event of self harm Self harming with information on how, where, what with, minimises risks Information: basic anatomy, physiology, first aid, wound care, correct usage of dressings, safer ways to harm

11. Why harm minimisation Supports person to take responsibility for their own behaviour Enables development of more healthy ways of coping Increases self esteem Increases assertiveness in a positive way by encouraging self management rather than management by others Encourages reduction in risk taking and promotes sense of control – 10 shared capabilities for mental health Allows individuals to define meaning of their own recovery

12. Self Harm Awareness and Skills training aims to: Increase awareness of different ways people may self harm Standardise understanding of self harm Develop appropriate and safe responses to self harm Raise awareness of self harm as a coping strategy Identify what staff need to feel confident with interventions

13. Who have we trained? Since June 2005 upwards of 2000 staff have received self harm awareness and skills training Emphasis on building capacity within organisations to respond effectively to self harm & to enable in-house delivery Encourages services to begin to develop policy that provides framework for intervention and increases staff confidence

14. How Has Training Evaluated Participants consistently report high levels of satisfaction with course Feedback indicates increased understanding of the function of self harm Increased confidence re self harm interventions and less fearful of responding inappropriately

15. What Participants Have to Say! “ I found this training really helpful and it will influence my work practice. Would be good to have regular input at team meetings.” “This was a fantastic course to really get you thinking about your practice.” “Self harm will now feature in our issue based programmes.” (Sourced from Choose Life evaluation forms)

16. Self Harm: Training for Trainers Need to capacity build Strategic and partnership approach to training delivery Self harm training embedded in diverse organisations and services Focus on creating responsive services Increased awareness across whole communities

17. How are we doing? Self harm training for trainers (T4T) course delivered October 2014 12 Participants from different authorities and diverse services Network of trainers created Plan to deliver another T4T 2015 12 training days scheduled Oct – March 2015 SPS Barlinnie Pilot

18. What T4T Participants Valued “ Shared experience of training, difficult situations & how best to deal with such incidents; greater understanding of self harm & increased confidence in sharing new knowledge.” “Great – quality, depth & breadth in terms of knowledge.” “This was an excellent programme and I’m delighted to have been a participant.”

19. For more information Contact: Allison.Murray@ggc.scot.nhs.uk