Understanding Self-Harm

I think I’ve explained that originally, my interest in this area of policing arose from professional frustrations; a professional lack of knowledge of what I could or could not do; what I must or must not do when responding to incidents.  I had no personal reasons to develop this interest and this crucially means I lacked a personal insight.

Frankly, probably along with many members of our society and many cops, I could not even begin to understand why some people self-harmed when they were in crisis.  As a constable and as a sergeant, I had been involved in detaining, restraining and / or arresting many vulnerable people who had self-harmed or were attempting to do so.  I could not see the necessity or the point: I just didn’t get it.  As such, the experience of policing events involving those who had self-harmed or were threatening or likely to do so, was frustrating to me because of my own perceptions: the sheer lack of necessity, as defined be me.

But this is not about me, is it?  If fact, the last thing it is about, is me.

The moment that it clicked for me, was during a night shift as a sergeant, when one of my officers and I arrested a young woman who had cut her arms apart again with a razor blade and who was head banging in her hostel when staff called the police.  After having to arrest her, we removed her to A&E for treatment to her arms and the young probationary constable I was with just asked her outright, “Why do you do this? I want to understand.”  I’d never thought to ask the question at all and both the answer and the subsequent exchange between the two of them over the next hour made it click.  For me at least.

The woman explained that it made her feel better.  The sensation of the pain, the physicality of bleeding was matched by a release of anxieties and fears which abated her depression and quieted down the voices she heard.  In short, it brought (at least) temporary relief from her demons.  She then said something quite innocuous which nailed it for me, although it still feels like a silly example, even now:  “Plenty of people get this from doing sport.  They go out to push themselves, end up pushing themselves to pain and hurt and derive both pleasure and a physiological, mental release.”  I play squash and sometimes you really push yourself; it hurts, you can’t breathe but it doesn’t seem to equate.  But something did click around the concept of ‘release’.

It doesn’t even make sense to me having typed it up; but something in my head clicked.    That she articulated it so clearly and rationally, whilst awaiting her cuts to be cleaned and dressed made me realise that to her, this was a rational act; regardless of what I thought.

Years later, a colleague in another police force rang for advice.  Officers in that force had attended a private premises to a call involving a known mental health patient who was self-harming.  Upon arrival, officers established that she was open to services and contacted the local MH crisis team.  Upon checking records, it was established that she had been seen earlier that day by her professional team and was believed to be doing OK.  The officers wanted advice about the fact that she was currently self-harming and were asked, “Is it serious self-harm or just superficial cutting?  If it’s just cutting, just let her get on with it, it’s what she does.”  And that was that.

After my ‘penny-dropping moment’ and the fact that I’d since spent three years working on nothing other than mental health issues for the police, I understood this.  I actually had to remember I’m a cop and think about what they’d be wondering, “How the hell do I know if this is serious self-harm or superficial cutting?!  I’m not a doctor?!!  Does she have the capacity to take this decision in light of its consequences?!  It’s all very well saying you saw her earlier today, but what if she’s taken something which has changed all the risks?!!  What if I think it’s superficial and leave her to do it, as per your advice, only to find she bleeds to death after I’ve gone?! I’m going to be asked the basis upon which I’ve assessed the incident, in light of your advice.  Anyway, even if I think it’s on the more serious side, I haven’t got any bloody powers in a private dwelling?!  Any chance of some help here?!!”  Or something similar.

This blog post is about something crucial to the policing of mental health incidents:  officers are often told that we need to have greater understand of and insight into mental health issues and what it’s like to live with them.  This often leads to calls for more / better training, perhaps including insight from service-users.  All fair enough – my own journey has done part of that for me.  Sympathy / empathy or lack of, for those at risk from mental illness, is one of the most remarked upon features of feedback to the police.

Although important, it’s not actually helping me police the event, though.  Not one bit.  Do we leave her there to her own devices and how do we determine that this is correct, safe and defendable; or do we intervene and if so, how and on what legal basis?  <<<  That is the training and the leadership we really need because all the sympathy / empathy in the world is futile if we then go and do the wrong thing and either leave someone at risk or criminalise them.

___________________________________________________________________________________________________________

BadgeThe Mental Health Cop blog won

– the Mind 2012 Digital Media Award, in memory and in honour of Mark Hanson.
The Awards celebrate the “best portrayals of and reporting on mental health in the media.”
– a World of Mentalists 2012 #TWIMAward for the best in mental health blogs.
It was described as “a unique mix of professional resource, help for people using services and polemic.”

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17 thoughts on “Understanding Self-Harm

  1. I honestly don’t know the answers to your questions but let me share my reasons. I wasn’t a teenager who ever self harmed (as most people think self harmers are), I was 30 when I first did it. I was in so much emotional pain and no idea how to deal with it and I’d read about people cutting themselves and so I decided to see if it would help me in some way. And it did! For that brief period of time, I felt physical pain and that was something I did know how to deal with. Over time it actually evolved in to a distraction technique. If I have suicidal thoughts, I have a 10 step plan to go through and hopefully somewhere a long those 10 things, the intense suicidal feelings would diminish slightly. Number 9 for me is self harm – it has the ability to put me back in the moment. I know that’s sounds totally irrational but it is actually quite rational!! Anyway those are my reasons – sorry if I’ve waffled on!!!

    Distraction technique

  2. Well I believe self harm is a seance of relief as if I didn’t srlf harm I would probably go crazy with anger,self harm is a seance of control
    To me I do it to feel in control feel real,
    Most people don’t understand why people do it could be meany reasons,
    Because of there past etc ,its annoying to me wen people judge us so quickly and label use

  3. That is definitely a predicament. I don’t know how you could judge that as a police officer. My thought would be to take the person to the emergency department for assessment and let the health professionals decide. I say this as a ‘superficial self-harmer’. If I self harm my mental health team are usually ok if I say it’s superficial, but sometimes I still go into ED for assessment of the injury. They get me assessed by the psychiatrist and cleared medically then let me go home. Even though wounds may be superficial they can get infected and it still shows that the person is experiencing psychological distress. My vote would be to have them assessed by a mental health professional, they are equipped to make the decision on what to do next, police have enough to deal with already!

    1. Thanks for that – then the challenge is the legalities of taking someone who doesn’t want to go; and whether the NHS will respond. Sometimes they do; sometimes they don’t: “We’re not a place of safety” etc., etc..

      Thanks for taking the time to reply.

  4. I want to comment, but I don’t know what to say! Enjoyed reading the post. I’ve had experience of the police and self-harm. I’ve always been treated by [the officers] them with dignity and respect and it’s something I’ve really appreciated. I think sometimes officers wonder if they are really making a difference and in my case they certainly did.

    1. That’s great to hear, and thanks for taking the time to say so; as often it’s only the negative stories that come out and I know they are real; but so are the positive stories that often don’t. Best wishes.

  5. I self harm when so depressed I have no feelings left inside of me and can no longer feel feelings coming at me. I do not cut for relief I pick and peel skin of so it hurts. It keeps me alive when near to suicidal from being dead in side

  6. The analogy between self-harming and sport particularly extreme sports is a good one. They are excellent for stress relief and maintaining good mental health. There have been a number of times that I have wondered what I am playing at while out on the water. Google Deadman kitesurfing trick to see the more extreme end. My main point is that there are alternatives FWIW.

  7. Great post – self harm is not well understood. The more public service professionals that understand it the better accepted ground-breaking projects will be that seek to teach self harmers safe-harm alongside other more traditional therapy-based interventions.
    Currently people recoil from approaches that involve things like teaching where to cut and how to avoid infection, this makes it really difficult to get funding support.

  8. I’m loving your blog – I found it through both of us being in MrsShorties carnival.

    I too get frustrated by the lack of help for people struggling with mental health problems as the help they get seems so antiquated and disorganised. Before I had kids I specialised in helping people with mental health issues. Now I don’t have the ability to be available 24×7 – but I hope that eventually all the books that I’m writing will build up to enough to at least help Mums who are struggling with it.

    1. Thanks, good of you to say so. I’ve also taken to this writing (of a blog) in the aim of helping police officers navigate their way through the maze and thereby do better for mental health patients. Always nice to see evidence of it helping, which is I did today and which is brilliant. I need to read this Mental Health Carnival stuff after offering to let my material get used!!

  9. You might be aware that yesterday, 2nd March, was self injury awareness day. In honour of the occasion the Guardian news site devoted a ‘Comment is Free’ page to the testimony of a woman who has self harmed written under the by-line of one of their sub-editors.

    http://www.guardian.co.uk/commentisfree/2012/mar/01/how-i-managed-to-stop-self-harming

    The article attracted comments including a number from middle aged and older men (including myself) who have self harmed well into adult hood.

    Self harm is often pictured as some thing by teenage girls cutting themselves. And the fact of teenage girls self – harming is something that deserves attention and education among the public at large. But self harm can be done by men, by middle aged and older adults and in a wide variety of ways. It is important that middle aged men and women who self harm can see that they are not alone in this and can have resources and support that they can tap into so that they might find safer and less despairing ways of coping.

    Unfortunately for me my experience of encounter with the police, when in my greatest desperation and in what was a real cry for help I self – injured on a public street (in Ireland), was that one of them (a plain clothes officer0 took great glee in physically laying into me and later taunting me to smash my head against the concrete wall of the cell. Strangely that calmed me down as the loathing and self hatred I felt for myself was replaced by fear of the police. Instead of experiencing humiliation of the weak and loathsome person I was by the good brave police officers that would have satisfied my feelings about how I should be treated, I was in the presence of a police officer who was acting quite evilly toward me, I was really in a very unsafe place.

    You might find it interesting to look at the article and some of the comments. It is quite short to read.

  10. I had a cop come to my house because someone called them on me for cutting he didnt want to talk to me rationally all he wanted to do was cuff me and i told hiim there was no need to cuff me he had them so tight i have marks on my arms and also my wrists are numb he had me out in my yard like a common criminal people staring at me as they went past i dont think cops understand self harm and when they come they wont listen i was willing to talk to the officer al he wanted to do was treat me like a criminal i even asked to call my grandma an i grabbed my phone to call her at which point and time he took it and tore the whole back off it i think the cops have no business dealing with stuff lik this in the first place he let me go but had a panic attack and it embarassed me the way it all went down he wouldnt talk to me or anything he justwanted to treat me like a criminal

    1. it could have been handled better i guess not all cops are bad but this guy was rude and wouldnt listen to me at all i was more than willing to talk to him his answer was just to treat me as if i had done something criminal 😦

      1. I’m sorry that all I can do is publish your comment to raise awareness and assure that overall, the negative stories I get about the police are very far outweighed by the positive ones. Got to keep chipping away to educate, I guess. I hope things are better for you now?

      2. thank you i appreciate that i had a bad experience but im just gonna try to put it behind me i know not all cops are like that and i suppose there will always be rude ones some may actually want to help but this cop i had dealt with didnt understand me or the situation i dont think

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