How often do you come across someone who has hurt themself? Often enough, I might imagine, what with your particular line of work. How about people who have intentionally hurt themselves?
Self-harm is an umbrella term that encompasses all sorts of behaviours, including eating disorders, alcohol and drug misuse, and self-injury.
Self-injury is directly hurting oneself, with the intention of relieving emotional distress. Health professionals often assume this means cutting the skin, but you might find people who bang themselves, or pick, scratch or burn themselves. Most people who hurt themselves like this bandage their own wounds, even if a cut really needs stitches to heal. Sometimes people get taken to A&E by a loved one, or occasionally take themselves if they're really frightened about blood loss, nerve damage or the pain.
You might, at times, get called out to someone in distress. Maybe the blood flow hasn't stopped, or maybe a family member is really worried and upset. Although you have many more life-threatening calls to attend to, I know you'll treat everyone with compassion and respect. I might guess, though, that you could feel somewhat frustrated, and I wanted to emphasise how important your approach could be. Each of us has mental health—just as you have physical health that fluctuates through the months and years, you have mental health too. Perhaps you talk about stress. Maybe you don't think about it too much yourself, but I hope you agree that mental resilience is crucial to your role.
While self-injury ‘helps’ a person deal with their turbulent emotions, it is of course a maladaptive coping mechanism. Yet, it is a coping mechanism still. The person you're attending to might feel it is the only resort they have when overwhelmed by negative feelings. They might be in a dire situation in real life, and not know how to handle things at all. They don't have to have a mental illness to resort to self-injury.
Because self-injury is such a secretive behaviour, you might be one of the first to discover that your patient hurts themself. The way you approach their care could either inspire them to accept further help in the future, or confirm (in their mind) that they need to hide.
Then again, you might come across people who frequently call for help, which in turn may be frustrating. I can only suggest that such individuals need more than patching—they need support to learn alternative coping strategies. Something we talk about a lot at LifeSIGNS.
LifeSIGNS is the charitable organisation I founded in 2002 to help raise awareness in the UK about self-injury. From awareness, we move to understanding. We have several fact sheets available, for health professionals like yourself, for people who self-injure, and their family members: www.lifesigns.org.uk/publications. LifeSIGNS offers information and guidance to people of all ages affected by self-injury.
Self-Injury Awareness Day (#SIAD) occurs every year on 1 March and encourages people to talk about their self-injury, as well as raising awareness through February. If you'd like to find out more, or direct people to our services, you can find us on Twitter, Facebook and LinkedIn: twitter.com/LifeSIGNS | facebook.lifesigns.org.uk | linkedin.lifesigns.org.uk