Mental health nurse Simone Garland provides a guide to the latest understanding of self-harm in teenagers and best practice for nurses in assessing and managing this vulnerable group
Self-harm in teens is very common and nurses and other health professionals who haven’t received training in self-harm are often the first point of contact.
This learning module will help you understand more about self-harm in adolescents, improve evidence based knowledge on the management of self-harm in this age group, in line with guidance, and gain confidence in advising and supporting patients at risk or with a history of self-harm.
Self-harm can be broadly defined into two categories: self-poisoning and self-injury. The latter can include self-inflicted injuries such as cutting, stabbing, jumping, burning or hanging. More than 50% of people who die by suicide have previously self-harmed.
Managing a young person who is self-harming can be challenging for everyone who is involved in their support. Nurses have reported feelings of anxiety, frustration, hopelessness, uncertainty and responsibility while working with adults and adolescents who self-injured. This can lead to negative attitudes towards those who present for help, especially for repeated self-harm.
However, it is important for nurses to be able to manage their attitudes and reactions to self-harm. Negative attitudes of stigmatising beliefs around self-harm impact the quality of care given and significantly influence outcomes.
Nurses’ responses and feelings around self-harm should be explored and supported through regular supervision with your practice or trust mentor and specific self-harm training. Having a basic understanding of self-harm and how to communicate positively and compassionately should be available to those professionals working with teens who self-harm.
Any disclosure of self-harm should be taken seriously and responded to compassionately, even if it isn’t the first time the person has harmed themselves.
The young person’s needs and wishes should be at the centre of assessments, decisions and safety plans. Collaborative working increases the therapeutic relationship and trust
Nurses supporting someone who is self-harming should be encouraged to use supervision to discuss and explore their personal thoughts and feelings around the behaviour
Training should be given to all health professionals who may come into contact with teens who self-harm to increase awareness of risk factors, interventions and how to respond in non-judgemental and person-centred ways
Whether community or hospital-based, it’s important for all nurses to recognise, first and foremost, that a young person is not self-harming for attention or to be manipulative. Self-harm is a response to extreme emotional distress and can be the only coping strategy a young person has.
Simone Garland is a mental health nurse working in the health and social care sector, and wellbeing coach at The Wandering Mind.
Finding this module
The full module can be found on the Nursing in Practice Learning website.
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