As a researcher specialising in self-harm, a common question I get is whether talking about self-harm encourages people to do it, or put more simply, “is talking about self-harm dangerous?” And the answer I give is an emphatic “no!”
Contrary to this widely held misconception, talking carefully and knowledgably about self-harm can not only help to dispel the misunderstandings around these behaviours, but may encourage people who self-harm to share their concerns, feel supported, and even to make the first steps towards seeking help.
Self-harm (defined here as any self-poisoning or self-injury regardless motivation or level of suicidal intent) is more common than most people expect. Over 200,000 presentations for self-harm are made to emergency departments in England each year. This is just the tip of the iceberg as self-harm in the community has been estimated in some studies to be 10 times more common. This is important, not only in terms of individual distress and the associated impact on friends and family, but because people who self-harm are more than 50 times more likely to go on to die by suicide.
There are a lot of misunderstandings about why and who might self-harm that contribute to stigma—one of the most common causes reported by people who self-harm for not seeking help.
Who is likely to self-harm?
While self-harm is most common in young women, self-harm can impact anyone, at any stage of life. For example, recently, the highest rates of hospital presentations for self-harm among men have been by those in middle-age, and people over 65 years who self-harm have a further increased risk of suicide.
Why do people self-harm?
The reasons for self-harm are numerous and vary by individual, but often people report using self-harm as a coping mechanism to relieve overwhelming emotions or distress. What we can say with confidence is that self-harm is not attention seeking, self-harm is not only about self-cutting, self-harm does not only affect young people, and self-harm is not always a suicide attempt. Self-harm may or may not include some level of suicidal intent, but all self-harm should be taken seriously due to the increased risks associated with it. These elevated risks persist no matter what method of self-harm is involved, or the medical severity of the act (for example, there is evidence that risk of future suicide is higher in people who attend hospital following self-cutting than in those who overdose).
To ensure that everyone stays safe, there are some things that should not be talked about in relation to selfharm. Graphic images of self-harm should not be shown or shared. Images can be very distressing to people who self-harm and can exacerbate the problem. Detailed descriptions of the different ways people self-harm (e.g. different or unusual methods, implements used to cause harm, etc.) should be avoided, as there is a risk that people who self-harm or are at high risk of self-harm might adopt these methods.
Finally, we NEED to talk about self-harm because it provides an opportunity to direct people to sources of support. A good start are online resources available via organisations like selfharm.co.uk and youngminds.org.uk where further information and guidance are available.
To find out more information about our upcoming conferences click here.
[Please note: If an individual is in crisis and at risk of hurting themselves, help can be sought via the GP or by attending the local emergency department
If you would like to know more about self-harm The Manchester Self-Harm Project has a learning resource available to access for free at manchester.ac.uk/mashlearning.]
Thank you to Dr Caroline Clements, Project Manager for The Manchester Self-Harm Project, University of Manchester who will be speaking at the 2019 Suicide Prevention Conference for providing us with this article.
Follow the conversation on 22nd January with #SuicideConf