Self-harm: offering young people support

Tags: Assistant Head | Child protection | Child Protection & Safeguarding | Child Protection Coordinator | Deputy Head | Headteacher | Peer Support | Well-being

Jessica Peters of the charity YoungMinds lays some common myths about self-harm to rest and explains how schools can support the young people it affects

Self-harm (also known as self-injury) in children and young people is a much wider issue that many would believe and is shrouded in a culture of secrecy and misunderstanding. Around one in 12 children and young people self-harm and approximately 25,000 are admitted to hospital every year due to the severity of their injuries. In an average classroom that means there are likely to be at least two children or young people who are self-harming in some way.

There is no ‘typical’ person who self-harms – it can affect anyone. However, information from parents suggests that the highest rate of self-harm is in girls aged 13 to 15 and about 11% of girls aged 15-16 have self-harmed compares to 3% of boys in the same age group.

‘It is important people understand why we self-harm… I was 14 when I started harming but it was tablets not cutting; it was the bullies and my abuser.’

Self-harm can take many different forms, some of the more common examples are cutting or burning parts of the body, often the arms or legs, taking an overdose, pulling hair or picking skin. There are also other behaviours that can be classed as self-harm such as drinking and taking drugs. 

Common misconceptions
There are many misconceptions about self-harm and the young people who do it. Some believe it is attention-seeking behaviour and others see it as a type of fashion statement but self-harm is a physical way of coping with stress and emotional distress. Usually the young person is struggling with another problem: they may be depressed or being bullied; perhaps there is a lot of pressure at school or home.

Contrary to some beliefs, self-harm is not generally about getting attention, it is a very secretive problem and a young person can self-harm for years before anyone notices or they find the courage to tell someone. More often than not there is an underlying emotional problem. Statistics show that 28% of 11- to 16-year-olds with an emotional disorder have self-harmed compared to the 6% who self-harm and do not have an emotional disorder.

Self-harm can be a coping mechanism that allows the young person to take control in a situation where they often have none. Whatever is happening in the outside world that cannot be controlled, they at least have control in what happens to their own body. Many of the young people that YoungMinds works with, say that when they self-harm it provides them with a release of pressure and allows them to think of something else other than their emotional distress.

‘I didn’t think or care about how deep I cut or whether the razor blades were clean.’

Staff training
There are an increasing number of pressures on schools and teachers to not only be able to recognise when a young person is having problems but to be able to support that young person in getting the help they need. This can only be possible if staff in schools are given the right training and support themselves – meeting the mental health needs of vulnerable young people takes particular care and flexibility.

Recognising self-harm itself is not easy; the young person is often very secretive and will inflict their injuries in places where a teacher would not generally see. It is important that school staff can identify which young people may be struggling with other problems such as bullying or exam pressure and understand that self-harm may be a way that the young person is dealing with events in their lives.

Like many other mental and emotional health problems there may be those who are more vulnerable to emotional distress, such as looked after children, young offenders or those who are from homeless families. Self-harm is strongly associated with young people who experience abuse, both physical and sexual. According to one study, about a third of girls and about 12% of boys who have been abused have self-harmed.

‘I think it’s important that there is more information not only on self-harm but mental distress in schools.’

Empowering young people
When staff can identify a young person who is self-harming the next steps are crucial. As self-harm is often used to gain control over their life it is essential that the care and support they are given is not taken out of their control. Saying ‘stop’ and ‘don’t do that’ does not work. If a young person has been using self-harm as a way of coping with their problems, it can be extremely detrimental to take away that mechanism without having the appropriate support in place.

Young people must be empowered to help themselves find other ways of coping with stress and emotional problems instead of using self-harm. Recognising the right of children and young people to be heard and have their wishes considered in their own care is essential in ensuring their recovery and supporting them to achieve their full potential.

‘It is important that we are involved and people stop treating us like freaks.’

As with talking about any emotional problem, trust is a key issue. Young people may confide in school staff as they are a familiar person who is not as involved as a family member or friend. It can be hard to understand why they may be self-harming but providing a non-judgemental support system that can help them find another way of managing their problems can make a considerable difference.

Peer support
Schools can be a key place where young people can find support and information for problems they are experiencing. Some schools hold health fairs where young people can find out more about self-harm or other emotional problems and what services are available in the local area. YoungMinds knows that one of the strongest elements in young people succeeding with their recovery is peer support. One of the overwhelming comments that YoungMinds hears from young people who are self-harming and suffering from mental distress in general is that they thought they were alone, they felt they were the only person going through those feelings. If young people themselves are trained and guided to support each other then their chances of recovery are greatly improved.

However, it is essential that the young people and staff are given adequate support themselves as coping with a friend or pupil who self-harms or is in mental distress can be a particularly difficult thing to deal with and can have consequences on their own emotional wellbeing.

Schools can be an ideal setting for creating support groups not only for young people who self-harm but to promote the idea of good emotional health and to tackle the stigma that surrounds this taboo subject. By opening a dialogue and providing a safe space to talk about their problems schools can play a major role in tackling the problems surrounding self-harm and other mental and emotional problems.

‘I have certainly cut down the number of times I self-harm because now I know there are people I can talk to instead, who’ve been there and understand.’

YoungMinds worked with a group of young people who self-harmed to create a training programme for an organisation, whether that is a school, youth group, Connexions service or A&E department, to develop their own self-harm strategy. The manual offers a method for taking groups of multi-agency staff and young people in your local area through a process of consultation, information sharing and decision-making.

All schools want to provide the best possible service for their pupils and the training manual gives guidance and best practice to allow your school, the staff and pupils to empower young people who self-harm.

‘We’re all people at the end of the day and if you don’t get an opportunity to talk about how self-harm really makes you feel, you really can get into a “you” and “them” scenario.’

Further information
YoungMinds’ free confidential telephone helpline: 0800 018 2138.
YoungMinds website: www.youngminds.org.uk
The YoungMinds training manual, See Beyond the Label: Empowering Young People Who Self-Harm, is available from the order line on 0870 870 1721

This article first appeared in Secondary Headship - May 2007

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