Raising awareness and dismissing myths is critical in establishing self-harm support groups says Steve Matthews of the Mentoring and Befriending Foundation.
Self-harm has often been considered a rare occurrence, but in fact it is becoming increasingly common. Although there are no national statistics available, surveys suggest that one in ten children self-harm.
A report by the Samaritans(1) found that 41% of those who self-harmed had sought help from friends before hurting themselves. They were less likely to turn to family, teachers, doctors or social workers. It also found that those who self-harmed had fewer people with whom they felt able to talk about problems compared with other teenagers. The report argues that prevention needs to take place in the community, ideally within schools.
This research was backed up by the national inquiry into self-harm among young people(2) in 2006. Young people told the inquiry that often all they want is to be able to talk to someone who will listen and respect them, not specifically about self-harm but about problems and issues in their daily lives. Many said that had this been available to them they may never have started to self-harm – ‘If there had been people to talk to at school then maybe I wouldn’t have felt the need to start self-harming then,’ was a response typical of many of the young people who responded to the inquiry.
The reasons for self-harm can be extremely personal but it is often a sign of emotion that needs to be expressed. There is also a great deal of secrecy surrounding such behaviour. Parental/ guardian awareness tends to be lower than among young people themselves.
Pupils who self-harm do so because they are finding something difficult and painful. They often suffer from low self-esteem, are socially isolated and may be under-achieving. It is therefore important to understand the meanings and feelings behind the self-harm.
Peer support models Peer mentoring, peer counselling or peer listening can be effective forms of support in schools for pupils who are self-harming. The facility to listen, to explore emotions and meanings are important in helping the young person to understand their self-harm. A key message from the national inquiry and the young people who were consulted is that they need preventative measures that are non-judgemental and respectful.
Mentoring and in particular, peer mentoring, can provide a non-judgemental response to a young person’s disclosure of self-harm. Schools need to agree about the model to be adopted, eg befriending, mentoring, counselling-based, mediation etc. There also needs to be a clear understanding about the role of their peer mentors – they are there to listen and not to counsel, although counselling skills can be particularly useful in the role.
While specific interventions such as peer mentoring can help, evidence shows (as has been found with anti-bullying strategies) that they are a lot more effective when they are part of a wider strategy within schools to develop the mental and emotional health of young people. A peer support scheme that is part of a whole-school approach may well help schools to meet the demands of the citizenship curriculum and help them work towards the National Healthy School Standard.
Sutton High School in Cheshire runs a peer mentoring self-harm project. The idea for the scheme originated from the need to support pupils who were struggling within school due to academic or emotional issues and were seeking relief from the traumas of self-harming. Sharon Jones, who coordinates the scheme, describes how the scheme originated from an anti-bullying project that saw a group of six pupils working together with anger issues.
During this time, disclosures were made about self-harming. The seriousness of this was discussed in depth with all staff and the learning mentors in school set about empowering the pupils to accept and understand the self-harming behaviour. The decision was made to develop peer mentors with training and experience in this area to support others who were experiencing similar difficulties. As Sharon points out, ‘It was decided that these pupils had so much to offer other pupils and due to their age would relate and interact far more positively than staff.’
Raising awareness Raising awareness and dispelling myths is critical to establishing any self-harm peer support process in schools. There needs to be a whole school approach adopted, with support from the school’s senior management together with the briefing and support of all staff. At Sutton High School, they have used a variety of ‘marketing’ techniques to achieve this, including staff meetings, transition presentations at primary feeder schools, communications with parents, flyers and media coverage.
Developing awareness and equipping mentors to deal with the issues that they may face is all part of the training that is required to establish a proper peer mentoring scheme. Most of the training that is needed to become a mentor is generic, such as empathetic listening, positive communication skills and generic counselling skills. Pupils also need to understand the boundaries of the mentoring relationship – when they may need time out themselves.
Confidentiality and child protection A peer mentoring scheme should work within the child protection procedures that already exist in a school. All schemes should have a confidentiality policy and know where issues of self-harm lie within it. Respecting a pupil’s right to confidentiality is critical and confidentiality should be maintained unless it is felt that that the young person may be at risk of causing him/herself serious harm. It is important that pupils can trust their peer mentors but it is just as important for everyone to know when confidentiality needs to be broken. Under these circumstances, pupils acting as mentors need to know what the procedures are if confidentiality is to be broken and what information should be passed on and who to pass it on to.
These policies and procedures must be explicit and covered in training and supervision. At Sutton, a confidentiality contract was formed and peer mentors had to agree to it and sign it as confidential disclosures might be made. This contract makes it clear that any information that the mentor deems as uncomfortable, or that they believe to be a child protection issue, must be passed on to the learning mentors immediately.
Professional support Peer support approaches, including peer mentoring are intended to equip school students with the skills to support each other effectively. It is not an alternative to professional counselling and other interventions or treatments, but it is an important intervention in its own right. Schools should always know when and where to access the support of other professionals when self-harm is recognised, including health, social services, and voluntary organisations.
Due to the challenging nature of issues like self-harm it is important to provide support sessions for peer mentors that give them the opportunity to ask for advice from other peer mentors. In the Sutton scheme, the learning mentors act as supervisors at all times and all peer mentors have group sessions every four to six weeks. The issues that they are dealing with can be upsetting, but even then, as Sharon Jones points out, often it is staff who find it most upsetting and who cannot cope.
Measuring impact As with any scheme, evaluation is critical in helping to understand the impact that the support is having on those involved. Although a number of schools have started to implement peer support, including peer mentoring schemes to deal with self-harm issues, the impact on people’s self harm is not yet clear.
At Sutton, they use feedback sheets from the mentees and mentors as well as verbal and written feedback from staff, parents, carers and outside agencies. Longer term outcomes can be measured through improvements in pupil behaviour, attendance and learning. But it is equally important to determine whether pupils’ attitudes to self-harm have changed as a result of the support that they have received. The future for such schemes is very much dependent on solid research being undertaken concerning their effectiveness. The Mentoring and Befriending Foundation (MBF) is currently involved in managing a two-year study of peer mentoring in schools.
This study, which involves 180 schools across the country, aims to assess the impact that different models of peer mentoring have on pupils attitudes, attendance, performance and behaviour and to develop guidance for future practice.
For further information about this project or to obtain guidance on how to set up a peer mentoring project, contact the MBF on 0161 787 8600 or email: email@example.com or visit the website at www.mandbf.org.uk.
1. Youth and Self Harm: Perspectives, Centre for Suicide Research/Samaritans (www.samaritans.org)
2. Truth Hurts, National Inquiry into Self Harm among Young People, 2006 (www.selfharmuk.org)
Self-harm: myths and facts
Myth: Self-harm is just a way of attention seeking.
Fact: Self-harm is a coping strategy. People self-harm because they are finding something difficult and painful. They could also be trying to show that something is wrong. They need to be taken seriously.
Myth: Self-harm is rare in young people.
Fact: Lots of people self-harm. There is lots of secrecy around self-harm and because many young people do not tell anyone, it is hard to know exactly how many are self-harming. The Royal College of Psychiatrists (1999) found that as many as one in 10 teenagers have deliberately self-harmed.
Myth: Young people self-harm over trivial reasons. Fact: All self-harm should be treated seriously. People self-harm to
different extremes as it is a coping strategy and everybody is unique. The extent of the self-harm is not necessarily a reflection of the seriousness of the person’s difficulties.
Myth: Once you have self-harmed you cannot stop. Fact: People can self-harm just once or twice. Some use self-harm over a long period of time. The frequency of the self-harm varies. Many people do stop self-harming but only when they are ready. This could be when they sort their problems out or when they find other ways to deal with
Source: The Learning Mentor’s Source & Resource Book, Kathy Salter and Rhonda Twidle, Paul Chapman Publishing, 2006.
- Learning Mentor’s Source and Resource Book, Kathy Salter, Rhonda Twidle, Paul Chapman Publishing, 2006 (includes a chapter on self-harm)
- A Guide to Creating a Self-Harm Policy, The Basement Project, PO Box 5, Abergavenny NP7 5XW
- Peer Support Manual: A Guide to Setting Up a Peer Listening Project in Education Settings, Jo Scherer-Thompson, Mental Health Foundation, 2002 (www.mentalhealth.org.uk)
- Setting Up a Peer Support Scheme, ChildLine, 2002 (www.childline.org.uk)
- See Beyond the Label – Empowering Young People who Self-Harm: A Training Manual, Young Minds, 2006
- A range of leaflets and publications on peer mentoring are available from the Mentoring and Befriending Foundation see www.mandbf.org.uk
- Young People and self-harm (National Children’s Bureau)
- SIARI (Self-injury and related issues)