Saturday, October 3, 2009

Deliberate Self Harm in Adolescents

I attended an information evening presented by Professor Carol Fitzpatrick, Consultant Child & Adolescent Psychiatrist on behalf of the Lucena Foundation in the O Reilly Hall in UCD on 10th September. The title of the information session was “Coping With Depression & Self- Harm - A Guide For Parents”

The main output from this evening was the following:

They covered a number of symptoms of depressive disorders in young people. Indicators such as low mood, loss of appetite, loss of sleep, low concentration, loss of interest or enjoyment in life and thoughts of suicide, over a period of time indicate that the teenager is depressed. Fleeting thoughts of suicide are common in teenagers, however, preoccupation with death and suicide is not. About 4-5% of adolescents are affected by depression and it is slightly more common in girls than in boys.

Not all depressed young people need formal help, support can be sought from family and friends for minor bouts of low mood and general feelings of being unwell. If the symptoms deteriorate and become more serious like self-harm, drug and alcohol abuse then formal intervention is required. The first step is for the parent to talk to the young person to understand what is going on in their life and to see can make changes to help them.

It is important also to look at the family dynamic to see what may underpin the behaviour – heavy drinking, being too busy, conflict in the home all these factors affect the child’s behaviour. Parent self-care is critical, so that the parent is able to deal appropriately with the situation. Another important factor to be aware of is how the other children are doing and how are they responding to this situation in the family.

In addition, if the teenager’s mood does not improve and the symptoms are ongoing and more serious such as suicidal thoughts and they have started to give away their possessions then urgent professional help is required. Visiting the G.P. or going to the A&E Department may be the only option available to you as a parent.

The most interesting part of this evening was information about a Space programme (Supporting Parents and Carers of Young people with self-harm) which has been set up by Temple Street Children’s Hospital two years ago. Deliberate self-harm (DSH) is a term used when someone injures or harms themselves on purpose. Common examples include ‘overdosing’, cutting, hitting or burning oneself, pulling hair or picking skin, or self-strangulation. DSH according to the Space programme is a behaviour that is used to cope with difficult or painful feelings.

This programme has been set up in response to the growing number of cases of young people presenting to the A&E department of Temple Street Children’s hospital, following incidences of deliberate self-harm. Up to now, this programme was operating in Temple Street and available to patients and their families who presented themselves for help. Due to additional funding, the hospital is now able to run this programme in the community. It is mainly available to parents and minders who find themselves in contact with adolescents who self harm. The contents of this programme include the following:

  • Support for parents
  • Information and education around DSH
  • Parenting, boundaries and communicating with adolescents
  • Practical skills around dealing with episodes of DSH
  • Re-establishing and rebuilding the family dynamic following DSH

Temple Street hospital also intends to run a programme designed to assist professionals who work with adolescents who self-harm.

Overall, an excellent programme and information evening.


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