Joanne first discovered that her elder daughter was self-harming when she was fourteen. The school rang to say she was not eating and was burning herself with hair straighteners. Joanne was shocked, and her daughter revealed that she had started harming herself after she was abused at the age of eight by Joanne’s former partner. Joanne took her to the GP, who referred them to CAMHS (Child and Adolescent Mental Health Service). They were assigned a community mental health nurse, who is still involved. Joanne says she is absolutely brilliant, helping her as well as her daughter. Joanne’s daughter was eventually admitted to an adolescent mental health unit as her weight was dangerously low. Her eating disorder is no longer a major problem, but she is very disturbed and suicidal. Her diagnoses have included post traumatic stress disorder, depression, and borderline personality disorder. Joanne is hoping to get a second opinion to be sure that she is getting appropriate care. Her daughter has harmed herself in various ways, including overdoses, cutting and ligatures, and over the last two years has been admitted three times. She hasn’t been to school during this time and is currently an inpatient under section.

Joanne says that when she first found out about her daughter’s problems she was hysterical and couldn’t stop crying. She couldn’t sleep and had three months off work. She was put on antidepressants, which she still takes. She now works part-time and has an understanding employer who is aware that she may have to deal with a crisis at any moment. Joanne says she has become hardened to the situation and copes by thinking that because there isn’t any help you just have to get on with it. Now she feels quite numb and immune and can deal with her daughter’s wounds in a professional way. It has been awful for her family. They haven’t been able to go on holiday for two years. Joanne feels she has not had so much time for her younger daughter, who has to be vigilant about concealing tablets and razors from her sister. She worries about her friends and had to have time off school. Joanne’s new partner is also affected, but Joanne doesn’t tell him the full details. Her daughter’s father tries to keep in touch with her, but she refuses to see him. Joanne thinks her daughter may blame him for leaving the family and thus in some way enabling the abuse to take place. He finds it hard to cope with and can’t understand why she would want to hurt herself, though Joanne tries to explain that it is a way of relieving her emotional pain.

Joanne does not feel she has been given much help by the clinicians involved in her daughter’s care. Although the community health nurse is very good and acknowledges that parents need support, Joanne is only able to have brief chats with her. After the first admission her daughter’s psychologist left and she has been on a waiting list since. She is also on a waiting list for dialectical behaviour therapy and Joanne hopes she will be moved to a more suitable hospital if funding can be found. Joanne didn’t feel included in her daughter’s treatment at first, but now the hospital ring her after ward rounds and have set up family therapy, though Joanne doesn’t think this is helpful. She would have liked someone to tell her it was not her fault, and to give advice on what to do for her daughter. She thinks there should be much more support for siblings, and would have appreciated a group where she could talk to other parents in a similar situation.

Joanne’s older daughter’s school was supportive, especially the school nurse, and someone from the school attended CPA meetings regularly, but the school has not been so involved recently as it is unlikely that she will return. Joanne has warned the school her younger daughter attends that she might be upset at times, and would have liked an advocate there to help her, but their attitude seems to be that if she is upset she should not go to school.

Joanne has found several websites useful. BEAT was good for the eating disorder; Young Minds is excellent and MIND is helpful for parents. She says Twitter is brilliant because she can be anonymous and talk about her daughter’s problems. She has many followers, including some young people who self-harm, who have told her it is helpful to them to see a parent’s point of view and understand what their parents are going through.

Joanne has followed people who are self-harming, and through their explanations of why they are doing it she has gained more understanding of her daughter, who was very secretive about her behaviour.

Joanne’s advice to parents is Don’t give up. Be alert but don’t beat yourself up if your child does harm themself you can’t be there 24 hours a day. Teenagers are secretive but don’t feel guilty about snooping’. Ask for help and do your research, but just know that it’s not your fault.’ Her message to clinicians is Please listen to the parents. We’re the ones who can help you to help our children. Sometimes our children won’t talk to you, but we can tell you about their background. Nobody has spoken to us enough.’

Joanne copes by keeping busy and putting all her effort into looking after both her daughters, who are her life. She says she’s always got hope and that’s what keeps her going. She would like to help other people so they don’t suffer like she does; she hopes to set up a parent’s support group once things have improved for her daughter.