Description The person physically deliberately hurts themself in some way or otherwise puts themselves at high risk of harm.
Referral and discharge following self-harm Pharmacological interventions Family support Prevention A comprehensive child and adolescent mental health service needs to take all the above facets into consideration when treating this group of extremely vulnerable patients.
The NICE guidelines emphasize the importance of treating patients who have self-harmed with the same care, respect and privacy as any other patient. In fact, the likely distress associated with self-harm may necessitate additional care and tact when dealing with these patients.
Also, health services are urged to provide appropriate training to all staff clinical and non-clinical that has any Self harm persuasive of contact with the patients to fully equip them with the necessary skills Self harm persuasive knowledge to effectively understand and care for people who have self-harmed.
Ideally, training should cover areas such as crisis counselling, risk assessment, stress management, mental health triage, cultural awareness, working with families and confidentiality issues Wynaden et al, These patients should be offered an environment that is safe, supportive and minimises any distress.
The NICE guidelines suggest a separate, quiet room with supervision and regular contact with a named member of staff to ensure safety at all times.
Young people who have self-harmed in a potentially serious or violent way should be assessed either by a child and adolescent psychiatrist, a specialist mental worker, a psychologist, a psychotherapist or a psychiatric nurse Hawton and James, The NICE guidelines propose that all people who have self-harmed should be offered this preliminary assessment at triage, regardless of the severity of the attack.
As the first point of contact, ambulance staff have a crucial role to play in the initial assessment of young people who have self-harmed NICE, The Australian Mental Health Triage Scale is a validated comprehensive assessment scale that provides a means of efficiently rating clinical urgency so that patients can be seen in a timely manner.
Research has shown the importance of cultural, ethnic and racial awareness and sensitivity in the assessment process. Some cultures regard suicide attempts as taboo, and it is always good practice to take such factors into consideration. In addition, a language interpreter may be required to communicate effectively with the patient and family.
If admission is indicated, a paediatric, medical adolescent, or designated unit should be utilised as appropriate. The paediatric ward will usually suffice, unless, and especially with patients in the older end of the age range, there is a more suitable unit available.
Waterhouse and Platt investigated the difference in outcomes between self-harm patients who were admitted to hospital and those were discharged as outpatients. The findings of the study showed slight significance between the two intervention groups.
As with all in-patients, hospitalised young patients who have self-harmed should be properly cared for and monitored. The Crisis Recovery Unit at the Bethlem Hospital in London, a national specialist unit for people of 17 years and above who repeatedly self-harm, have a different and slightly radical approach to the in-patient treatment of these patients Mental Health Foundation, Their philosophy is that the individuals should take responsibility for their actions.
This practice-supported technique focuses on helping young people realise for themselves that self-harm is not an effective strategy for dealing with their problems. It encourages these patients to talk about their problems and explore alternative coping strategies, including strategies for dealing with the urge to self-harm.
However, the effectiveness of such an intervention in younger patients is not certain, as these children might not be mentally mature for such self-realisation tactics.
Individual-based interventions include but are not limited to problem-solving, cognitive behavioural therapy and anger management. Family therapy could be in the form of problem-solving or structural or systemic therapy, and group therapy could involve any of these techniques performed in teams or groups.
Problem-solving Therapy Problem-solving therapy or brief psychological therapy as it is otherwise known, is a brief treatment that is aimed at helping the young patient to acquire basic-problem solving skills to identify and prioritise their problems Mental Health Foundation, The process involves implementing discussed possible solutions to a specific problem, and reassessing the situation to review progress -sort of like a self-audit process.
The basics of problem-solving therapy as identified by Hawton and James are highlighted below: This finding has been variously collaborated in other studies and the results are considered reliable.
This therapeutic process usually takes 5 to 6 one-hour sessions, and can be delivered by any experienced mental health professional with suitable training and supervision Mental Health Foundation, It is direct and easily understood and is thus suitable for the younger patients. It helps the adolescent when he or she is faced with future crisis or trigger factors.
Although widely used adopted in psychotherapy in the treatment of depression, cognitive behavioural therapy CBT has limited evidence of use in self-harm patients. Even in depression, its use has been shown to be less effective as monotherapy than fluoxetine monotherapy and in combination with fluoxetine March et al, Dialectical Behaviour Therapy Dialectical Behaviour Therapy DBT is an intensive therapeutic technique that was introduced to help those who repeatedly harm themselves.
It could involve as long as a full year of individual therapy, group sessions, social skills training and access to crisis contact Mental Health Foundation, Fewer behavioural incidents have been reported with this treatment when compared with an input unit run on psycho dynamically oriented principles Katz et al,thus strengthening findings by Rathus and Miller in In addition, an older study Linehan et al, had shown very significant differences in likeliness to repeat self-harm in patients undergoing dialectical behaviour therapy and the control group.
The NICE guidelines suggest the use of dialectical behaviour therapy in self-harm patients who have a diagnosis of borderline personality disorder, but stress that this should not preclude the use of other strongly validated psychological treatments with vast evidence-based support.Cutting and self-harm can be a way of coping with problems.
It may help you express feelings you can't put into words, distract you from your life, or release emotional pain. Afterwards, you probably feel better—at least for a little while. But then the painful feelings return, and you feel the. Self harm involves many types of personal injury, from poisoning to starving, though cutting is the predominant method of self injury (Lakkanen et al, ) and because of this, I have ensured to differentiate cutting, from other means of self harm within this review.
Self-harm or self-injury means hurting yourself on purpose. Learn about why people self-harm and treatment and coping. Self Harm research papers examine the direct intentional injuring of the body without committing suicide; also known as deliberate self-harm (DSH).
The cause for self harm could be brought on by things such as; bullying, abuse in which this case the victim may think they deserve the pain then inflicting it on themselves, mental health problems and depression which is a leading r-bridal.coms: Essays - largest database of quality sample essays and research papers on Self Harm Persuasive Essay.