Sal McKeown looks at the reasons behind self-harming, and how apps can help
According to the Mental Health Foundation, 10% of young people self-harm. That is three in every secondary classroom. It is especially high in the LGBTQI (lesbian, gay, bisexual, transgender, questioning/queer or intersex) community. Hospitals in the UK report 200,000 cases of self-harming each year.
The urge can start at any age, but most people who self-harm are aged between 11 and 25. They are more likely to start if they know someone else who's done it, such as a friend or a family member.
Those who self-harm are more likely to end their own life than others. However, many don't want to end their lives. In fact, some experts believe self-harming may help them cope with emotional distress, so they don't feel the need to kill themselves.
Self-harming is more often than not a private act and so allegations that it is attention-seeking are wide of the mark. Often people are only discovered to be self-harming after repeated episodes when they have built up a tolerance and need to hurt themselves more to get the same release.
Common reasons for self-harming
- Abuse: emotional, physical or sexual abuse including bullying
- Bereavement: death of a family member friend, or pet
- Emotional and mental health difficulties: worry, panic attacks, depression, anxiety, loneliness
- Relationships: problems with family, friends, teachers
- School worries and exam stress: pressure from parents and teachers, fear of failure
- Substance abuse: alcohol, drugs or both
- Gender identity or sexual orientation: uncertainty, keeping it secret, facing hostility. According to Queer Futures, published in 2016, just under half of young LGBTQI people have self-harmed.
- To replace emotional pain with physical pain
Treatment for self-harming
Like some addictions and eating disorders, the impulse to self-harm comes in waves, builds, reaches a peak and then falls away. One of most commonly used forms of treatment is to distract affected individuals by engaging them in an activity until the urge passes.
Talking to experts, talking to friends, getting access to information, hearing other people's experiences and the strategies that have worked for them, can all be helpful. However, services are stretched and the overwhelming need to self-harm does not always occur in daylight hours.
Technology can help. It is available day and night, and provides information and access to sources of support. However, searches on a computer or on the internet can leave a trail and may not be as confidential as the user would like, so many organisations, especially universities, have been busy developing apps. Users can download an app onto their mobile which goes with them everywhere and, by using location services, they can find local sources of support.
Apps for self-harming
Bluelce has been created with the help of young people who have self-harmed. It lets users rate their current state of mind using a simple dashboard system and then offers mood enhancing activities such as physical action, ways to identify and challenge negative thoughts, relaxation, and mindfulness exercises. It includes a mood monitoring diary and a personalised self-help menu of music and photo libraries.
Calm Harm has been developed for the UK-based charity Stem4. It has four approaches: 'Distract' helps to combat the urge by learning self-control; 'Comfort' helps users choose a care solution rather than harming themselves; 'Express' lets out feelings in a different, less damaging way; while 'Release' provides safe alternatives to self-injury. Each category offers some strategies, such as, 'Write down what you are stressed about and tear it up'.
distrACT, developed by Bristol Health Partners with support from other local and national organisations, is aimed at 16 to 24-year-olds. Content is divided into six areas, including sections on dealing with feelings and managing the urge; where to get local and national support; an emergency section for first aid or suicidal thoughts, and a chill zone of art, videos, music and other creative interests which help people get new perspectives and insights. Dr Asha Patel is CEO of Innovating Minds which provides mental health first aid training to young people, schools and community groups, and was instrumental in developing the app. It empowers them to take control of their urges and intrusive thoughts, she says. ‘Coping strategies, such as holding ice cubes and felt tip pens sound simple but they are very effective and can save lives.'
MyGRIST created by Aston and Warwick Universities is about safety issues associated with mental health problems. It helps users to manage their own personal safety, understand the things in their life which put them at risk, collect and record data, decide if they need to seek help with their problems, and explain their feelings to others.
Self-Heal was developed by students at the University of Oxford. It starts with three options: short term strategies, longer term strategies, or immediate actions such as calling the Samaritans. It also provides a long list of resources and information for further help, photos, and inspirational quotes. This is a powerful visual distraction with more than 750 pictures, many of which are captioned to be thought-provoking and to engage the user.