This resource, Self-Harm and Suicide, will help professionals to understand the difficult problems of self-harm and suicide among young people and provides a background to interventions, facilitation and staff training

Written by Tina Rae and Elizabeth Smith

It looks like a shocking statement, but recent statistics show that one in every fifteen teenagers has resorted to self-harm, suggesting that Britain has one of the highest levels of self harm in Europe.

In the government’s recent report ‘Truth Hurts’ on the incidence of self-harm amongst teenagers, it became apparent that not only is this problem is presenting an increasing risk to the youth of the UK, but also, that those people who are in constant contact with young people (namely teachers like yourself) are ill equipped to deal with these issues.

For some time now, it has become increasingly evident that the school environment plays a significant role in the shaping of young people’s behaviour and emotional functioning (Rutter et al 1979). More recently, it has also been recognised that the school context is also one in which therapeutic change can be fostered (Kolvin et al 1981). For this reason Self-Harm and Suicide was written.

This may sound like a desperate situation and though you cannot change the society that teenagers grow up in, you can, with the right backing and expertise, provide valuable support that enables them to work through issues and gain the help they need without having to resort to desperate methods.

This is where Self-Harm and Suicide: The Professional Development File can help.

Self Harm and Suicide is a resource designed to help anyone who works with teenagers to begin their path towards supporting the difficult problems of self-harm and suicide. The book has been written specifically to make sure that professionals are aware of the issues that teenagers are tackling today and also give them accessible tools to be able to approach these challenging issues with them.

The resource contains 3 INSET training activities written for staff development as well as 10 sessions that can be worked through with students. It comes with a power point file with back-up training resources and an audio cd of diary entries that are to be used alongside the student activities.

Self-Harm and Suicide offers:

  • background information on the theoretical reason for these forms of behaviour
  • valuable guidance on ways to identify those who may be at risk
  • practical ways to react and prevent this ever increasing risk
  • the tools you need to enable you to help any of your pupils who may be dealing with this type of problem.

What can you expect from Self-harm and Suicide (published in October 2008)?

The book is split into five sections:

Part One: Understanding Self-Harm and Suicide
Part One includes an introduction on understanding self-harm and suicide as well as information on:

  • definitions   
  • rates of self-harm
  • why self-harm?
  • myths and stereotypes
  • suicide
  • suicide rates and responses
  • risk factors

Part Two: Proactive Interventions
Part Two of the book gives you an introduction into the reasons that self-harm and suicide rates are high in teenagers and addresses the following issues:

  • emotional literacy
  • definitions of mental health and mental health promotion
  • cultural views
  • limitations of interventions
  • referring on – the legal position
  • teaching successful distraction techniques
  • policy for schools
  • working with other colleagues

Part Three: Staff Training and Support for Facillitators
Part Three of Self-Harm and Suicide offers and overview of the importance of training for staff along with:

  • the importance of training and supervision
  • referrals to specialist agencies
  • problem-solving therapy
  • dialectic behaviour therapy
  • cognitive behaviour therapy
  • family therapy

Part Four: Staff Training – Working with Groups of Young People
This part of the book consists of an accompanying power point presentation and facilitator notes which will help to raise awareness in all staff along with three activities:

This activity simply involves general small group discussion and feedback focussing on the following key questions:

  • What is self-harm?
  • How common is it?
  • Can it be prevented?
  • How can we better respond to people who self-harm?

This activity requires staff to consider two statements made by young people as part of the ‘Truth Hurts’ (2006) inquiry and consider what the implications of these two statements might be.

This activity asks staff to reflect upon the importance of peer support. Staff can discuss the feasibility of developing and maintaining a peer support scheme and undertake the following:

  • Describe the scheme

  •  Identify factors that need to be considered, for example:

        – training         – location         – support and supervision systems         – resource implications

        – Health and Safety and Child Protection implications.

Part Five: The Programme
This section is designed as a ten session programme which can be delivered to groups of young people in a school or youth education context. The ten sessions are designed to cover the main issues surrounding self-harm and suicide in young people and to provide a safe framework in which students can develop preventative strategies and techniques alongside recognising the importance of peer support and appropriate access to therapeutic agencies.

  • Structure of the Programme

The programme is divided into ten sessions as follows:

Session One: Ground Rules and Definitions

In this session the students are asked to consider what they understand self-harm and suicide to be. They are asked to participate in a myths and realities activity so as to ensure that accurate and informed information is available to them.

Session Two: What Causes Young People to Self-harm?

In this session the students are asked to focus on the different stresses in their lives that may cause mental ill health, such as schoolwork and fights with parents and friends.

Session Three: Things We Do That Self-Harm

In this session, students consider the different forms of self-harm and the fact that self-harm is on a continuum ranging from minor physical abuse to suicidal thoughts, feelings and intent.

Session Four: Strategies Scenario

In this session the students are asked to consider a scenario in which a student describes her self-harming behaviours. They are asked to identify the factors that may or may not have contributed to this behaviour.

Session Five: Helping Friends Who Self-Harm

The students here are asked to consider ways in which they may or may not be able to help friends who participate in self-harm.

Session Six: Coping Skills

In this session there is a particular focus on developing stress management techniques and strategies. Students are asked to share their own coping strategies alongside being introduced to a range of strategies which help to prevent mental ill health.

Session Seven: A Suicide Attempt

Students are presented with another scenario in which a student attempts suicide. They are asked to consider the impact on family, friends and those involved with the individual concerned.

Session Eight: Media

In this session the students are asked to consider how sensational reporting and unhelpful websites can cause problems for individuals who access them.

Session Nine: Bereavement

In this session students are asked to consider the process of bereavement and how losing a loved one or a significant other can impact in a way that can cause or lead to self-harm or abusive behaviours and suicide.

Session Ten: Conclusion and Evaluation

In this session the students are provided with a forum in which to discuss all of the issues covered in the course and to evaluate the way in which the course has been presented. They are asked particularly to focus upon how they might modify any of the activities or change the activities, particularly with regard to their emotional responses to specific areas of the work.

Structure of the Sessions

Each of the ten sessions in this programme is structured in the following way:

  • Icebreaker: An icebreaker activity is used to break down any barriers and create a relaxed and empathic ethos within the group. Icebreakers usually take the form of a Circle Time game or activity.

  • Practical activity: Practical activities are then undertaken in smaller groups in order to introduce and reinforce the concepts covered in the session.

  • Diary: In this part of the session, the students are asked to consider the diaries of imaginary students and a parent of a suicide victim (male and female). The student diarists are either involved in self-harming behaviours or have suicidal thoughts and intent. The students are asked to listen to each diary as it unfolds. The diaries are presented on audio CD. There are then questions for Circle Time that the students are asked to consider directly in relation to the diary entry they have just heard.

  • Activity page: The activity page activity is intended to reinforce the concepts covered. It may or may not be undertaken within the session itself. It can be used as a reinforcement sheet or a take-home task.

  • Plenary: In this session students are asked to consider what they’ve actually learnt in the session; how they feel about their learning, how they feel about the issues covered and how they would like to proceed in the next session. Would they do anything differently or would they like things to be presented differently in order to further alleviate any of the stresses caused by the material covered?

  • Self-harm and Suicide covers issues surrounding the causes of self-harm, such as stress levels as well as getting pupils to understand the reasons why people may resort to self-harm or feel suicidal, in order to remove the stigma around such behaviour.

The resource supports a whole-school approach to mental health promotion through the development of environments in which staff and students gain the skills and support systems to ensure their well-being. It provides a safe framework in which students can develop preventative strategies and techniques alongside recognising the importance of peer support and appropriate access to therapeutic agencies.

It is suitable for professionals working with adolescents in a range or educational, social and clinical contexts and the student programme is suitable for young people aged 13 – 18 years.