Messages to health services and schools about self-harm

Parents and carers of young people who self-harm share their messages for health services and schools.

Health service professionals

Helping parents

Many parents stressed the importance of being included by clinicians in their child’s treatment (see also ‘Mental health services – involvement of families‘). Charles advised ‘the more you can involve the parents, either with or without the patient, the better, so that we have a better understanding of what is going on and what the prognosis is.’ People thought clinicians would also gain more understanding of the family situation by asking parents about it. As Ann said, ‘We’re the ones providing the support and care for the majority of the time when they [clinicians] are not around.’ Liz agreed: ‘Just listen to parents. They do know. They know their child better than anyone.’

Joanne advises clinicians Listen to us. Were the ones that can help you to help our children.

Age at interview 44

Gender Female

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Nicky thinks carers should be included as part of the solution.

Age at interview 48

Gender Female

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Some parents commented on the way clinicians spoke to them. Philip said: ‘Remember that we don’t all understand the jargon.’ Jane S recommended that healthcare professionals should get feedback from parents so they could ‘speak the same language’ to other parents and avoid being too clinical. Joanna and Anna advised clinicians not to dismiss parents because they were not medically qualified. Nicky told us it would be helpful if clinicians explained to parents why they were suggesting some things, for example how to cut safely.

Parents should be included, not dismissed, says Joanna.

Age at interview 46

Gender Female

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Nicky thinks parents would be reassured if clinicians explained their perspective more clearly.

Age at interview 48

Gender Female

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Anna thought it essential for treatment plans to be acceptable to parents. ‘Don’t impose on parents, work with parents to see if things are workable within the home, and if parents are happy with that, because it won’t work unless you’ve got parents on board working with you to help it go through. Because if you haven’t got parents at ease with things, they’re not going to follow through.’

Parents wanted health professionals to recognise the impact of self-harm on the whole family. Ann would have liked to be asked how she was coping herself, but realised this might raise hopes which couldn’t be met: ‘If you say, ‘Well actually, I’m not coping at all’, where do they go with that, because there isn’t anywhere to go with it?’ Bernadette thinks carers’ medical records could be marked so their situation could be recognised when they visit the doctor.

Bernadette thinks if carers can be identified through their medical records they could be offered support.

Gender Female

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Helping young people

Several parents said it was important for healthcare professionals to be sensitive to the needs of young people who self-harm, to take them seriously and not judge them. Vicki thought GPs should find out more about self-harm and not ‘brush aside’ people who come to them with problems. Annette and Fiona said clinicians should avoid a ‘tick-box’ approach, and treat people as individuals. Mary sometimes felt that the message she received was ‘Well, we haven’t got time for this’. Her advice to healthcare professionals treating her son is: ‘Don’t dismiss it. Recognise that it’s something that the family has to deal with and perhaps needs some advice and reassurance about. Don’t just say, ‘Oh yes well, he would.’ Or brush it off.’

Susan Z would like clinicians to take young people who self-harm seriously and be more compassionate.

Age at interview 58

Gender Female

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Fiona thinks people will be more open with therapists if they know they will be treated as an individual and not labelled.

Age at interview 57

Gender Female

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Professionals should be sensitive in treating people who self-harm, recognise that they are needy and reassure them, says Sandra.

Age at interview 49

Gender Female

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Suggestions for improvement

Although they recognised that health services were often underfunded and staff overstretched, parents suggested ways in which things might be improved. Some would have liked easier access to services. ‘I think CAMHS [Child and Adolescent Mental Health Services] are a bit over stretched in what they can do and the time they’ve got available to do it’, Tracey told us. ‘It almost felt to me as if we’d have to be practically asking my son to step down from the top of the building before he could access those services and to me that’s too late.’ Annette thought a 24-hour drop-in service would be useful. Ann said there should be local psychiatric admission units where people in crisis could be taken instead of to Accident and Emergency departments where staff were busy and not trained in mental health issues. She also wanted the out-of-hours service to provide support by coming to her house when her daughter was suicidal. Susan Y would like individual sessions where she could speak in confidence to her daughter’s therapist.

Tracey found it hard to get help and thought it should be easier to connect with services.

Age at interview 52

Gender Female

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Jackie thought that Emergency Departments in general hospitals should provide talking centres’ and give advice on ways to avoid self-harm.

Age at interview 40

Gender Female

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Parents thought more information and practical advice should be available. Tam suggested having leaflets about self-harm in doctors’ waiting rooms. Mary had been given leaflets but thought they could be improved: ‘they’re so general that they don’t actually say anything’. She wanted more practical care advice.

Jane S thinks parents should be given more information and advice, and that negative attitudes towards people who self-harm should change.

Age at interview 54

Gender Female

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Schools

A few parents had ideas about how schools could deal with the problem of self-harm. They thought schools should be able to identify young people who need help and refer them on to appropriate services. They also suggested that information about self-harm should be included in the curriculum, including how to spot signs of distress and the dangers of drug overdoses.

Tracey thinks schools should be aware of self-harm and know what to do about it.

Age at interview 52

Gender Female

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Susan Y says schools should provide education about self-harm and mental health issues.

Age at interview 47

Gender Female

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Jane Z suggests a unit about self-harm and how to cope with it should be part of the school curriculum.

Age at interview 49

Gender Female

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Thoughts about the future

The parents and carers we spoke to told us their thoughts about the future and their hopes that their child would go on to fulfil...