Assess And Respond To Individuals At Risk Of Self-harm Or Suicide Week 4


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Assess and Respond Weeks 4 to 9

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  • Assess And Respond To Individuals At Risk Of Self-harm Or Suicide Week 4

    1. 1. Assess & respond to individuals at risk of self harm or suicide Understanding self harm / injury
    2. 2. Self injury vs Suicide <ul><li>Handout : Differentiating Suicide attempts from Self injurious behaviour </li></ul>
    3. 3. Self injury: A definition <ul><li>A pervasive pattern of deliberate mutilation of one`s own body with the intent to cause injury or damage, but without suicidal intent, in order to provide relief from an intolerable emotional state, usually beginning in adolescence, and marked by the following: </li></ul>
    4. 4. How do you handle your emotions ? <ul><li>Group Activity </li></ul><ul><li>E.g When you are angry with someone do you tell him/her ? Or do you keep your feelings to yourself ? Or do you snap or lash out at others ? </li></ul><ul><li>Intense emotions: Do you prefer to be alone or with others ? </li></ul><ul><li>Do you try to find ways to escape rather than deal with feelings or problems directly ? </li></ul><ul><li>How do you communicate your feelings to others ? </li></ul>
    5. 5. Defining Self injury <ul><li>Recurrent impulses to physically harm oneself </li></ul><ul><li>Intrusive, obsessional thoughts about self injuring. </li></ul><ul><li>Intolerable emotional states of emotional numbing & dissociation </li></ul><ul><li>Feeling of both physical & psychological relief after the act of S.I. </li></ul><ul><li>Multiple episodes of S.I. </li></ul>
    6. 6. Defining Self injury continued <ul><li>Low lethality </li></ul><ul><li>Impulsivity in other areas that are potentially self destructive (e.g. AOD, eating disorders, high risk or dangerous behaviours such as: reckless driving or becoming involved in abusive interpersonal relationships. </li></ul><ul><li>A general pervasive mood of depression or anxiety </li></ul>
    7. 7. Statistics of Self injury <ul><li>Underreported </li></ul><ul><li>Secretive behaviour </li></ul><ul><li>Prevalence rate of 1000 / 100,000 (1%) </li></ul><ul><li>Other sources: 1400 / 100,000 </li></ul><ul><li>Violent & anti-social youth- 40% </li></ul>
    8. 8. Characteristics of Self injury <ul><li>Done to oneself </li></ul><ul><li>Performed by oneself </li></ul><ul><li>Physically violent: hitting, cutting or burning </li></ul><ul><li>Not suicidal </li></ul><ul><li>Intentional, purposeful not accidental </li></ul><ul><li>Typically, first appears during adolescence </li></ul><ul><li>Tends to peak in early to mid twenties </li></ul>
    9. 9. Characteristics of S.I. cont`d <ul><li>Often begins to decline in 30`s </li></ul><ul><li>Repetitive episodes with patterns of increasing frequency & severity as time goes on </li></ul><ul><li>Loses its effectiveness over time: occurrence decreases with age; regardless of any intervention </li></ul>
    10. 10. Characteristics of Self injurers: <ul><li>Poor impulse control </li></ul><ul><li>History of childhood illness or severe illness or disability in family member </li></ul><ul><li>Difficulty in forming stable relationships – leading to “social exclusion” </li></ul><ul><li>Fear of change </li></ul><ul><li>Poor self care </li></ul><ul><li>Low self worth </li></ul>
    11. 11. Characteristics of self injurers cont`d <ul><li>Childhood history of trauma </li></ul><ul><li>Rigid all or nothing thinking (catastrophic thinking) </li></ul><ul><li>Perfectionism & workoholism </li></ul><ul><li>Constant fear, anxiety or heightened alertness </li></ul><ul><li>S.I. creates experience of pain & increased tension / arousal </li></ul><ul><li>When S.I. stops : emptiness, dullness etc </li></ul>
    12. 12. Hidden Scars, Silent Wounds <ul><li>Show video & handout question sheet </li></ul>
    13. 13. Self injury & mixed messages <ul><li>Self destruction vs Survival </li></ul><ul><li>Group Activity : T- shirt Front “ What I am really feeling “ Back “ What others see “ </li></ul>
    14. 14. Helping someone who self injures <ul><li>Recognising the symptoms & Assess the risk of self harm or suicide </li></ul><ul><li>Listening non-judgementally </li></ul><ul><li>Provide support & information </li></ul><ul><li>Encouraging the person to seek professional help </li></ul><ul><li>Encourage the person to use self help strategies </li></ul>