Step Up! International

Feedback and reports have shown a lack of self harm awareness in the medical profession and subsequent negative mistreatment of individuals who self harm. A GP or hospital personnel can be an individual’s only option at times, yet if the practitioner has no knowledge of how to approach self harm or fails to address the individual with respect and dignity, they cannot sufficiently help someone who self harms.

According to a recent documentary ‘Failed by the NHS’, exploring how young people suffering from mental illness fail to receive the correct treatment by NHS services, approximately 50% of patients who self harmed were not treated or seen to by medical services. This, according to Professor Nav Kapur University of Manchester, is “potentially a missed opportunity to prevent future self harm or even suicide.” Although the other half are seen to, it is the neglected amount which gives cause for concern. Rachel Jones, a recipient of anorexia, explains how visits to hospital focussed more on weight gain rather than addressing her mental health. The documentary sadly highlights the much needed care individuals require and how spending for the mental health service has dropped for the second year in a row causing insufficient care.

photo from: http://www.nhs.uk/

Feedback and reports of negative ways in which practitioners from the medical profession have reacted included: Showing visible shock or disgust, talking down to a person, blaming the individual for ‘wasting time’ and distracting from real medical emergencies and also insufficient treatment. These real life reactions can be the result of lack of self harm training and lack of self harm awareness on part of the medical profession. Staff nurse Jo McHale and lecturer Anne Felton carried out a study assessing self harm training within the medical profession and produced an interesting mix of promising and concerning results. Nurses, for example, felt that with lack of support in helping someone who self harms they experienced feelings of failing their duty of care, however with special education and training in self harm awareness they felt a more positive attitude as they were better informed of various ways of offering self harm help.

Some simple changes which could be implemented in order to provide patients help for self harm and better care in the medical profession, include:

• Listening attentively to individuals and showing genuine concern in order to reassure them.
• More staff receiving self harm awareness training
• Acknowledgement that some individuals may not need psychiatric referral after the first visit.
• Awareness that an individual’s reason for self harming may be different for each visit so incidents must be treated separately.
• Staff receive more support from team members and senior managers in relation providing relevant and/or more appropriate for people who self harm
• Staff receive training to manage their own emotions when dealing with someone who self harms

Many sectors of society including the medical profession must be fully trained and equipped in order to provide people self harm help and prevent neglect of mental health issues. With medical personnel receiving increased self harm training, it is hoped that patients will receive an improvement in treatment and services.

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“Ask Jennifer” – Free Webinar: Self Harm and Self Injury

Date: 24 September 2013

There are many sectors in society which can help manage the prevention of self harm, these include; medical and health, media, education, support foundations and so on. This is why it is vital for the government to bring awareness to helping those who self harm through these sectors and more. By looking into the progress these sectors are making with self harm awareness we can determine where more attention is needed and what is working so far.

Since the year 2000 the government has heavily financed the health sector in order to aid those who self harm, however some experts question this move claiming the government should aim to reduce stigma and approach practical prevention rather than mere ‘crisis management’. Dr Andrew McCulloch, chief executive of the Mental Health Foundation, argues the 16-25 year old age group of individuals who self harm would likely veer away from specialist clinics. By associating with mental health such organisations would make particularly young individuals feel uncomfortable. This is why places such as youth centres, sports clubs and schools would be valuable to help those who self harm as they are more familiar to that particular age group. By drawing attention to the simple and non specialist methods for self harm we can encourage individuals to step forward for help and also reduce the belief that self harm is solely a mental health issue.

Aside from young people, other areas of society demand the government’s attention such as immigration for example. Figures released in 2010 claimed a rise in self harm cases in immigration detention centres leading to the development of the Assessment Care in Detention and Teamwork (ACDT). This allows staff to be trained to assist and properly treat self harm and suicide.

According to the Mental Health Foundation however the treatment and misinformation about self harm has not really changed. Professionals such as teachers and GPs have limited knowledge on the issue, thereby reacting negatively to individuals making them reluctant to ask for help, especially children. After conducting the ‘National Inquiry into self-harm among young people’ 6 years ago, the same study carried out recently showed little change in results.

Whilst it can be argued that changes are being made in approaches to self harm awareness, evidence suggests there is more to be done. Attention must be drawn towards the health and education sector where those who self harm are likely to seek help, as well as other sectors. Recent exposure in the media has shone a light on the reality of self harm such as a BBC’s ‘It’s a Mad World’ season with documentaries highlighting mental illness within the football world, mental ill health amongst teenagers and even debate shows on the status of mental health in the UK. This goes to show that attention is being drawn to self harm and although certain perceptions and ideas still have not changed, as with many sensitive and challenging issues the government have to deal with, it takes time.