This document discusses the role of alcohol in self-harm and suicide, particularly among women and young girls. Data from the Self-Harm Intervention Programme (SHIP) shows that over half of women referred had consumed alcohol. The Northern Ireland Registry of Self-Harm also found high rates of alcohol involvement in female self-harm episodes across different methods. Reasons for self-harm and subsequent alcohol abuse are proposed to include a variety of traumatic life experiences and feelings. The document advocates for greater education and understanding of emotional health and the effects of alcohol, as well as increased responsibility from the drinks industry.

1. THE ROLE OF ALCOHOL IN
SELF-HARM & SUICIDE
THE PERSPECTIVE OF WORKING WITH
WOMEN AND YOUNG GIRLS
CONOR MC CAFFERTY
ZEST: HEALING THE HURT LTD

2. SHIP: THE SELF-HARM INTERVENTION PROGRAMME
2015-PRESENT
• PUBLIC HEALTH AGENCY INITIATIVE AS PART OF THE ‘PROTECT LIFE’, N.I. SUICIDE
STRATEGY
• ‘SHINE’ PILOT 2009-2015……REFERRAL FROM COMMUNITY MENTAL HEALTH
TEAMS AFTER EPISODE OF SELF-HARM/ATTEMPTED SUICIDE … 3000+
REFERRALS RECEIVED 18+ AGE GROUP
• 53% WOMEN
• SHIP TO-DATE (18 MONTHS) 1400 REFERRALS RECEIVED 54% (N=760)
WOMEN REFERRED
• OF WHICH 56% (N=420) HAD ALCOHOL TAKEN

3. N.I. REGISTRY OF SELF-HARM: 3 YEAR REPORT
2012/13 – 2014/15
ALCOHOL INVOLVEMENT IN FEMALE SELF-HARM EPISODES BY METHOD 12/13/ - 14/15
• DRUG OVERDOSE ONLY…………..46%
• SELF-CUTTING ONLY…………….....40%
• OVERDOSE AND SELF-CUTTING…....46%
• ATTEMPTED HANGING ONLY……....38%
• ATTEMPTED DROWNING ONLY……35%
• OTHER………………………………35%
• UNDER 18 FEMALES ALCOHOL INVOLVED IN 16% OF SELF-HARM PRESENTATIONS

4. Reasons for Self-harm: Life-experiences:
• Sexual abuse
• Neglect
• Emotional abuse
• Extreme lack of communication
• Physical abuse
• Loss/separation
• Parental illness/alcoholism
• Witnessing family violence,
• Excessively high expectations,
• Racism, sectarianism,
• Bullying and rejection by peers,
• Fear and shame about puberty or sexuality

5. REASONS FOR SELF-INJURY:
Feelings caused by life-experiences:
Emotional pain
• (Sadness, grief, hopelessness desperation)
Self hatred
• (Shame, guilt, dirtiness)
Anger
• (Fear, hurt, frustration)
Anxiety
• (Fear, tension, panic)
Neediness
• (Isolated, lonely unsupported, unheard)
Unreality
• (Invisible, numbness, deadness)

6. • Empty nest
• Women in the workplace
• Women and education
• Lifestyles
• Alcohol advertising
• Ladette culture
• Self-medication for the feelings
Underlying Reasons for alcohol abuse

7. Emotions are the physical manifestation of what’s going
on in our heads:
• E ‘motion’ = move outwards,
• We see it in young children e.g. joy, happiness,
excitement, sadness. hurt, fear, frustration, anger etc.
• In many cases the ‘big people’ create acceptable and
unacceptable feelings e.g. “I’ll give you something to
cry about….”
ALL EMOTIONS ARE NATURAL
and essential for our wellbeing

8. Ethanol C2H6O, is made up of elements of the following 11 chemicals:
1. Acetic acid: vinegar
2. Acetone: cleaning solvent
3. Benzene: petro-chemical, highly flammable
4. Carbon tetrachloride: dry-cleaning agent, used in fire extinguishers,
one of the most potent liver poisons
5. Ethylene glycol: anti-freeze,
6. Glycerol: anti-freeze, dynamite
7. Nitromethane: super-glue solvent, fuel for drag-car racing
8. Pyridine: insecticide, ‘paraquat’
9. Toluene: paint thinner, disinfectants, octane b2ooster in fuel
10.Chloroform: anaesthetic
11.Diethyl ether: anaesthetic (C2H5)2O
(surgical anaesthesia starts at equivalent of 350mg/100mls blood)

9. Not Sleeping!!

10. Not Sleeping!!

11. Clinically Unconscious

12. Ethanol
(alcohol dehyrogenase/glutathione)
Acetaldehyde
(acetaldehyde dehydrogenase)
Acetic Acid
Carbon Dioxide
Water (90%)
4 CMO’s in Feb 2016, “no safe number of units”
1 unit per hour and half

13. Alcohol poisoning!!!

14. Ladette Culture

15. Onset of Depression

16. Overwhelming Depression

17. 7th Stage of Intoxication: Death
(500mg/100ml blood)

18. WHAT WE NEED TO DO
• EDUCATE EVERYONE IN EMOTIONAL HEALTH
• EDUCATE EVERYONE IN THE ‘REAL’
CHEMISTRY OF ETHANOL
• MANDATORY MODULE OF PROFESSIONALS’
TRAINING
• MAKE THE DRINKS INDUSTRY TAKE
RESPONSIBILITY
• MINIMUM PRICING PER UNIT/LABELLING
• GREATER EMPHASIS ON THE EFFECT OF
ETHANOL ON THE EMOTIONAL HEALTH
• STOP SEEING ALCOHOL ABUSE AS ‘BAD
BEHAVIOUR’ BUT RATHER AS THE PERSON’S
‘SOLUTION’ TO HER LIFE EXPERIENCES
• MORE COMPASSION AND UNDERSTANDING

19. WHAT MAKES OUR SERVICE WORK:
COMPASSIONATE
APPROACH WITH THE
‘PERSON BEHIND THE
BEHAVIOUR’ TO IDENTIFY
THEIR ‘PAIN’ I give you my ears, my eyes, my
undivided attention and my heart

20. THANK YOU