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Introduction: Self-Harm
Self-harm is a very personal and private act with a great taboo surrounding the health problem. Self-harm has a huge impact on the day-to-day lives of those who do it. Guilt is felt is on enormous levels as is the effort in trying to conceal their actions. There are many people who feel unable to speak out about their self-harming for fear of the stigma and shame linked with self-harming actions.
In order to deal with distress, self-harm is a response to profound emotional pain. It offers self-release from feelings such as self-hatred, anger, sadness and depression. The most common methods are: (www.nursingtimes.net/nursingtimes/pages/selfharmandunderstandingthecausesandtreatment)
Ð* Cutting skin over and over
Ð* Swallowing small amounts of toxic substances
Ð* Burning and scalding
Ð* Banging and scratching
Ð* Hair pulling
Ð* Excessive substance abuse
Most professionals, families and friends who are in contact with a person who self harms, knows very little about the subject. In 2004, two organisations worked together to produce what was described as a landmark report into the understanding of self-harm. (www.swpho.nhs.uk/resource/view.aspx?rid=24055) The objectives of this campaign will be explored and the success of the campaign will be evaluated for whether the SMART targets have been achieved.
The Report
A national enquiry into self-harm among young people was launched in the House of Commons on 30 March 2004, making it the first of its kind. The campaign was called or when the Department of Health was accused of not taking self-harm among young people seriously. (www.swphonhs.ukresource/view.aspx?rid=24055)
The campaign called for the government to launch a UK wide initiative to develop better and more appropriate responses to young people who self-harm, starting with an awareness programme targeted at professionals, parents and young people.
Jointly run by The Camelot Foundation and The Mental Health Foundation, the campaign focused on deliberate self-harm injury among 11-25 year olds in the UK. It was set up and conducted by a panel of experts, young people with experience of self-harm, researchers, policy makers, front line workers, and representatives of mental health services, who met every three months over a two-year period.
Five initial target locations were chosen because there were five organisations with strong records for working directly with young people with self-harm. They were Derry, Newcastle, Cardiff, Aberdeen and Galashiels. The initial plan was to source personal testimony, expert opinion, research and contributions from professionals, parents and young people as their target audience.
Eventually, there was a UK wide call for evidence and the campaign was advertised in newspapers, magazines and other publications. In March 2004, the website w ww.selfharmuk.org was launched in a further attempt to gain views, knowledge and experience. The campaign report was released two years later on 26 March 2006.
Aims of the National Inquiry
Research
Knowledge and understanding
Educate and raise awareness about self-harm
Make policy recommendations
Training and good practice
Shifting culture
The reason for focusing on self harm was that there was only a small body of evidence existing that self-harm was a serious public health problem. The statistics at the time indicated that self-harm was behind 142,000 admissions to accident and emergency departments in England and Wales every year. (Hawton,K&Fagg,J.(1992).Deliberate self-poisoning and self-injury in adolescents: A Study of characteristics and trends in Oxford,1976-1989.British Journal of Psychiatry,161,816-23) Evidence also indicated that the age of onset of self-harm was twelve years of age.
High Risk Groups Identified
Despite relying on personal experiences from young people that self-harmed, the campaign also relied on statistics and findings from hospitals, GP surgeries, school nurses, and a questionnaire was devised and handed out to school children anonymously. It soon became clear that there were definite high-risk groups. They included young people in:
Ð* Closed settings Ð- armed forces, boarding schools
Ð* Custody Ð- prisons, young offenders institutes
Ð* Gay, bisexual and transgender young people
Ð* Black and minority ethnic groups of young people
Ð* Learning difficulty groups of young people
There was a high incidence of people dealing with these issues as well:
Being bullied
Physical or sexual abuse
Poor family relationships
Problems with girlfriends/boyfriends
Drug use
Having known a person who attempted/committed suicide
Low self image/self esteem
Poverty
Parental marital problems Ð- separation/divorce
Disrupted upbringing Ð- periods of staying in Local Authority Care
Unwanted pregnancy
Fear of rejection
Stress