A Training & Education Officer’s Perspective of Seeing Narratives Shift

By Helen Birch (Training & Education Officer)

Through my role as a Training & Education Officer within the Academy at Harmless, I have the privilege of sharing knowledge and evidence-based interventions. I aim to create a safe space for curious dialogue on mental health, self harm and suicide, while challenging stigma and harmful language. I also employ my own lived experience to place authenticity at the heart of the training journey and add real-life context to the activities, statistics, research and information we share.

The feedback we receive is overwhelmingly positive, as is the shift we see in participants’ confidence, knowledge and thought-processes around the issues of self harm and suicide. It is truly wonderful to see the impact our work has.

However, sometimes I can get taken aback by feedback, as was the case in my most recent training session. Following a day-long Self Harm Awareness course for frontline professionals, this feedback was given verbally at the end of the session – and it brought tears to my eyes and goosebumps to my skin.

In my role, I often hear stories of inappropriate language and care practices being used towards those who are struggling with their mental health. While this can sometimes be upsetting, it also presents the perfect opportunity to challenge, and these are opportunities I relish.

In the context of inappropriate language, challenging someone doesn’t mean putting them down, belittling or shaming – it’s about taking the opportunity to educate. In this instance, an example was shared of a staff member telling another within an inpatient facility to ‘just ignore an individual struggling with self harm as giving them attention is what they want, and will only encourage them keep doing it’. This language is harmful, stigmatising and not recovery-focused – a type of ‘care’ that invalidates and creates a dangerous malaise within services, where bad practice can perpetuate and create a non-iterative cycle.

This type of ‘care’ can also cause detriment to the staff providing it, as well as those observing. It can be caused by or create Health Care Professional (HCP) stigma, where professionals:

‘…may develop their own biases from their upbringing or even from burnout in their own working roles, HCP stigma may develop very much the same as the social stigma evident in the general public, this may create a barrier to the overall well-being of individuals by preventing adequate treatment, but it also may impact the acknowledgement of their disorder. Overall, health professionals may not provide adequate intervention, early detection, or community referral options for individuals with mental or behavioral disorders, because of their own stigmatizing beliefs and personal histories’
(Ahmedani B. K. (2011). Mental Health Stigma: Society, Individuals, and the Profession. Journal of social work values and ethics, 8(2), 41–416)

It can also lead to staff leaving services due to the negative impact on their own wellbeing. Therefore, challenging inappropriate language has so much potential to make positive changes for everyone.

At the beginning of the session in question, we asked participants to respond to a series of statements and whether or not they were related to self harm. This exercise offers our first opportunity to gauge, engage, dispel myths and challenge harmful language. In this instance, a high proportion of participants thought self harm was attention-seeking and that the behaviour would be with someone for life. This is absolutely not the case and feeds into historical myths and misconceptions around the subject, highlighting an ongoing lack of education, knowledge and understanding.

This is where Harmless – the centre of excellence for self harm and suicide prevention – comes into its own. We have the perfect platform to break down the impacts of these misconceptions and use our training to shift mindsets. Our courses encourage reflection on personal views, and involve activities that enhance growth and understanding.

As the session progressed, I could see this process in action. From the participants’ interaction and questions, it was clear that they sought to understand the subject better, and learn how they could implement the training into their specific roles. It had been a rewarding session for all of us even before the icing on the cake – the verbal feedback.

The participant acknowledged that what they were witnessing – and being asked to do – in their professional role was wrong. They had known this anyway, but the training session had confirmed it. They then went on to say how the training had given them the confidence to challenge those practices and ensure that patients would receive the compassion they deserve.

The delegate was particularly moved at hearing that we must always treat each episode of self harm as if it is the first and with the same care, compassion and patience – even if in reality it is the fourth or fifth episode of the day. Each individual episode may be someone metaphorically screaming for help.

This participant had a power and determination in their voice that I had not heard in a delegate before. It was emotional to witness and underlined to me just how vital our work at Harmless is.

It takes just one person to make huge changes – changes that ultimately save lives.