No SecretsSupporting those affected by self-injury

Self-injury awareness:•No Secrets – history and progress•Self-injury (inc. NICE guidance)•My personal story (Kerri Jones)

WARM UPExercise 1

Why No Secrets started...

• Co-founded Oct 2007 – 2 volunteers• Lack of support• ‘Alone’ – me and family• Lack of understanding• Nobody spoke about it• “No Secrets” – how we want it

Our Mission• To provide a safe and supportive environment for

anybody affected by self-injury• To raise awareness of self-injury• To tackle stigma associated with self-injury

We aim to achieve the above by providing peer support, providing awareness-level training,

running awareness campaigns, communicating with as many as possible and working closely

with local health services.

Since October 2007...• Group 1 St Helens continuing to run• Group 2 Wigan started early 2011• Group 3 Halton launched May 2011• Group 4 Family/friend support – 20th July @ PB• Continual awareness level training to over 200

people• Local press, Saints (RLFC), ‘Pick Me Up’, BBC News• Now have 10 volunteers• Successful activities/fundraisers

Sponsored Abseil – St Helens

Sponsored mountain climb

Donut men – Wigan group 2011

No Secrets in one sentence...• “A feeling of belonging and that I’m not alone”• “Means I can make a difference to other people’s

lives”• “Support and guidance, and friends when you

need it most”• “People understand self-harm, and me”• “No Secrets is a fantastic place to open up and

meet new friends”• “A safe place just to ‘be’”• “I belong!”• “People committed to improving lives”

No Secrets in one word...

• “Friendly”• “Helpful”• “Reliable”• “Super”• “Hope”

From Wigan & St Helens group members in, April 2011

• “Happy”• “Inspirational”• “Accepted”• “Friendship”• “Peace”

Self-injury

Definition adopted by NICE:“intentional self-poisoning or injury, irrespective

of the apparent purpose of the act”.

Not always connected to suicide. Majority preventing suicide.

2 categories: Self-injury and self-poisoning.

Self-injury/self-poisoning

• SI - Cutting, swallowing objects, insertion of foreign objects into body, burning, stabbing.

• SP – overdosing with medicines, swallowing poisonous substance.

• Self-injury more common than self-poisoning, this is not reflected in statistics.

• People who self-poison are more likely to seek professional help.

NICE: Clinical need for guidance

• 150,000 presentations to A&E each year• UK rates are amongst highest in Europe• Half of the 4000 people who die each year by

suicide will have self harmed at some point• Self-poisoning most commonly seen in ED’s • Cutting most common form of SI• 100x more likely than general population to die

by suicide, whether intentional or accidental

Information from Clinical guideline 16

NICE: Key priorities for implementation

• Respect, understanding and choice• Staff training• Activated charcoal• Triage• Treatment• Assessment of needs and risk• Psychological, psychosocial and

pharmacological interventions

Information from Clinical guideline 16

Risk factors & life events• Single• Divorced• Live alone• Single parent• Severe lack social support• Disadvantaged background• Victimisation (domestic abuse, sexual abuse etc)• Alcohol/drug use

Information from Clinical guideline 16

Psychological characteristics

• Certain characteristics more common in SH:• Impulsivity• Hopelessness• Poor problem solving

• Nearly ½ those presenting to ED’s with SI meet criteria for having a PD (though this can bring it’s own problems)

How many self-inflicted injuries did Warrington A&E treat within the space of 9 months (1st April- 31st Dec) in 2010

What percentage of that 802 were male?

What was the average age of all 802 people who presented to Warrington

A&E?

WHY DO WE SELF HARM?• Relieves tension• Punishment• Calming/self soothing• Focus shifts from emotional to physical• Control• Adrenaline rush• Numbness/detached - “It makes me feel alive”• Anger and self-hatred• Depression “jeckle and hyde effect”• Very upset• Problems can seem smaller afterwards• Anxiety

IF ONLY YOU COULD GET IT!

• Self harm makes me feel something when I feel numb

• I don’t do it for attention• I’m hurting myself, nobody else• It’s mostly easier not to tell anyone I’ve done it• A bigger wound doesn’t mean worse feelings• We can have accidents too

It helped when…• The professionals working with me weren’t scared

of talking about self harm.• My support worker expressed they wanted to

understand as much as possible• Somebody accepted that self-injury is my way of

coping for the time being• I was told to be ‘safe’ rather than told not to do it• People truly believed I didn’t want to keep hurting

myself, even though it didn’t come across that way• I was offered support after telling somebody about

my self harm, rather than being told I was seeking attention and being manipulative.

It really didn’t help me when:• People said I was being stupid or I should have

known better• Staff got annoyed with me after I’d harmed, for

not talking about it before I did it• A&E staff refused me pain relief• Someone took all my sharps away (where no

suicidal intent present)• I heard people laughing at me• Staff said they were disappointed in me• I was reminded of those who I love and told how

much I was letting them down• People made a big deal of it when they didn’t

need to

In summary

DO DON’TTalk about SH and ask if you are unsure

Ridicule/put me down

Understand as much as possible and reflect on your actions

Blurt out responses

Accept Treat differently from everyone else

Be Safe Remove my only coping mechanism

Believe & encourage Laugh/make fun of

Non-judgmental support Focus on negatives of SH

Generally, focusing solely on negatives to self-injury will make person feel worse. Try to explore a variety of potential positives and negatives (Sharon)

My story• Abused in early childhood• Uni, deaths (april – Aug), cutting and suicide

attempts 2005-2006 - SIPU• 2007 Started voluntary work and co-founded

No Secrets with mum• Extent of abuse accidentally revealed to family• Reported abuse to police• Self-injury – as long as remember. My release

from overwhelming feelings of sadness, self-hatred and anger.

What I’ve learned since initial breakdown

• Honesty is vital• Acceptance important• Actively work on tackling problems• Help others with similar issues• I’m not alone• I’ve achieved more than I thought capable• Anchors – family, friends, pets

Open Q&A

• This is your chance to ask any questions around self-injury and/or mental health problems

• We will always be honest and do not worry that any questions will act as a trigger

• We want you to be honest• Bring up anything you may want to discuss within

the group• Your questions help us to see how it is from your

perspectives

Feedback and check out

• Share with the group what you have learned from this session

• It’s important that we remember that anybody can be affected by self-injury. If you have been affected by this session try to speak to somebody before you leave

• Check-out... What are you going to do this evening?

Evaluation

• We would be grateful if you could complete the evaluation form for us to feedback your own thoughts on how this session went

• This will help us to improve and continue the work we are doing

Thanks!More details can be found on our website:

http://nosecrets.moonfruit.com For more information on the WIGAN group, contact

Kerri on 07846 889 300 or email kerri86@gmail.com

For more information on the ST HELENS or HALTON groups contact Tina on

07863 736 647 or email tina.sthelens@gmail.com

Thank you for your support!