Anna’s husband died by suicide after a long period of illness when their daughter was ten years old. Anna says her daughter found it difficult to express her feelings about this, and was in contact with bereavement and trauma services. When her daughter was 15 Anna was shocked to discover that she was cutting herself seriously. She hid sharp objects in the house and planned with her partner how they were going to manage the situation. Anna and her partner both work as teachers and had experience of young people’s self harm through their work. Anna decided to be very open with her colleagues and to make use of the pastoral care system for her daughter. For about six months they had to cope with self-harming behaviour which involved the police, ambulance crews, social services and community mental health teams, all of whom were very supportive. In the home, Anna imposed strict rules, for example monitoring her daughter’s online and mobile phone use and cancelling accounts if appropriate. She emphasises the importance of consistency in this tough love’ approach.

After a bad patch of self-harming Anna’s daughter was admitted to a psychiatric unit, where she learnt about different methods of self-harm. Anna felt that she could manage her daughter better herself, and took her daughter out of the unit after six weeks. She encouraged her very talented daughter to focus on career goals and revision for her exams. The school counsellors supported this by talking to her daughter about all her other interests and not emphasising the self-harm, which enabled her to fit back into the school community easily and move on. During a period when her daughter was off school, Anna encouraged her to take up activities which involved contact with normal’ young people, rather than other self-harmers through internet blogs. Her daughter hasn’t harmed herself for two years. She is doing well at school, has a good social network, and is applying for a university place.

Anna had mixed experiences with mental health services. She was very angry with the psychiatrist who was responsible for her daughter’s inpatient admission but was pleased with the CAMHS team’s support for the whole family. Although she was initially reluctant to talk to counsellors, Anna accepted this because she thought it would help her daughter. She and her partner were given the opportunity to express their feelings and work out coping strategies. On the whole she was given the support she wanted she says she wasn’t frightened to ask for help and to be clear about what she and her daughter needed.

Anna had to take some time off work to be with her daughter, but she didn’t miss many lessons and says her boss was very tolerant. The CAMHS team helped by arranging appointments after school hours.

Anna thinks her daughter’s self-cutting was a means of expressing intense feelings which she couldn’t put into words. Now she is able to talk and write about how she feels. Her daughter also took overdoses, which Anna sees as an attempt to reel in’ her mother and reinforce the very close relationship they had following her father’s death. Anna says it’s important that her daughter always felt loved and was never blamed. Anna’s partner couldn’t understand why anyone would want to cut themselves and found it rather horrible, but he stayed calm and worked with Anna as a team in dealing with the situation.

Anna’s advice to other parents is to hang on in there’ and take regular breaks. She recognises that parents can feel powerless and recommends setting consistent boundaries in the home so parents have a sense of control. She says it’s easy for clinicians to think they know everything and parents know nothing: they should avoid talking down to parents and instead should listen to them and facilitate open communication. Too often parents don’t feel like they’ve got a voice. She advises clinicians not to impose on parents, but to work with them to help their child.