Self harm Awareness Day, a professional reflection

Written by Harmless Clinical Lead, Ana Silva.

This week marks a significant moment in time for us. Self harm awareness day takes place every year on March 1st. Harmless was set up in 2007 with the sole purpose of turning a dream into the reality of having a community service dedicated to supporting everyone who self harms or is at risk of, their carers, families, and friends alike, and the communities in which we all exist.

Every year we host the national self harm conference on this week, and this year we lead on the development of a new branding and media pack to be distributed as widely as possible to bring greater attention to the day (you can download a pack by clicking here.).

Like us, around the world organisations come together in sharing global messages of hope, action, and in some cases, concern for the future ahead and what it means for clinical services and the many people supported by them.

And right now, here in the UK it is almost impossible to think about these matters without it being in the context of hardship and uncertainty. The cost-of-living crisis continues to develop and increasingly impact the lives of our clients, and our staff. At a time when referrals for services continue to reach record numbers, the Government announced it has abandoned the 10 year dedicated Mental Health and Wellbeing Plan in favour of a new Major Conditions Strategies that will include ‘mental ill health’ alongside other groups of conditions such as cancers and cardiovascular diseases. At the same time, a new suicide prevention strategy is being developed and will soon be released. The implications for clinical practice are vast and complex. Many relevant organisations have expressed their thoughts and concerns, including our CEO Caroline Harroe (you can read more here The U.K. Mental Health plan – Harmless).

For now, I simply want to share a few reflections on why these matters are important for us. We know self harm can happen to anyone, at any point in the lifespan. The evidence tells us it is more common in young people, yet older individuals are far more likely to die by suicide. We also know that what helps may not be the same. The important thing here is that self harm relates to suicide. And in clinical practice, if we’re going to do something about it… we must do it quickly. Because we know that if people repeat self harm (with repetition being linked to increased risk), they do it quickly too. 30% of people will do it in first month, 10% in the first 5 days. Therefore, promptness is key. It is vital – quite literally so. When people have access to a prompt psychosocial assessment followed by psychological care, they are 40% less likely to repeat it.

And so, the question becomes, how can do we do so? And how can we do it well, at a time where pressure is felt like never before? The answer is simple but not easy, and it lies here – the value of having a humanising contact in the interaction between client and clinician, between one person and another person, as soon as possible after self harm. A contact that is kind, authentic, and curious. An interaction that is skilled and informed by evidence. Individual yet collaborative, problem solving and instilling of hope. One that confidently and reassuringly asks about suicide, whilst always knowing the person is not their behaviour. A contact that is an intervention, whilst it efficiently connects people into services for follow-up and care plan enactment.

I did say it was simple, not necessarily easy. Because whilst some of these things are fundamentally human attributes, other are inevitably skill based, reliant on thorough and specialised training from places that are just as skilled in understanding the complex phenomena that is self-harm and suicide. And to do that whilst resources are scarce and funding inadequate… that is where the challenge lies.

At Harmless, the harder things get, the more we go against the grain and fight for our staff and their welfare. Because if we’re not here to continue help our clients, what is going to happen?

Ana Silva, Clinical Lead