R

Excuse me if this site becomes a little self indulgent, a little about me, a little about the beautitful people I have met. Not all self harmers, but most who were troubled and all who made an impression on me & it may help me process my feeling of loss
..., luv Abz

Intentional self-harm NSW Department Of Health

Data table

View data table

Note

Includes suicide (attempted) and purposedly self-inflicted poisoning or injury. Hospital separations were classified using ICD-9-CM up to 1997-98 and ICD-10-AM from 1998-99 onwards. Rates were age-adjusted using the Australian population as at 30 June 2001. Numbers for 2006-07 include an estimate of the small number of interstate hospitalisations, data for which were unavailable at the time of production.

Source

NSW Admitted Patient Data Collection and ABS population estimates (HOIST). Centre for Epidemiology and Research, NSW Department of Health.

Commentary

Completed suicide is only one outcome of intentionally self-harming behaviours.

One other outcome of these behaviours is hospitalisation. It is not accurate to regard hospitalised self-harm as equivalent to 'attempted suicide' for comparison with 'completed suicide'. There is some overlap between hospitalised self-harm and suicide, as some suicide deaths occur after admission to a hospital, however, hospitalised self-harm is more frequent than completed suicide. (Steenkamp et al, 2000).

Most people who contact health services after an episode of intentional self harm are seen by emergency departments. They may or may not be admitted as hospital inpatients, and the injury may or may not be recorded as intentional. In recent years, there have been more than 10,000 hospital separations per year following an episode of intentional self harm.

Hospitalisation rates for intentional self-harm are consistently higher in females than in males, while the death rates from suicide are about 3 - 4 times greater in males than in females. This is thought to be mostly due to males using more lethal methods than females. The numbers of young females aged 15-24 hospitalised for self harm has begun to decrease after a peak in 2004-05 (483.0 per 100,000 in 2004-05), however the numbers remain significantly higher than among any other age group (435.6 per 100,000 population compared to 185.3 per 100,000 for females of all ages in 2006-07).

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For more information

NSW Department of Health. Suicide prevention in NSW. Sydney: NSW Department of Health, 2003. Available at www.health.nsw.gov.au/pubs/s/pdf/well_suicide.pdf.

NSW Government New South Wales Interagency Action Plan for Better Mental Health Sydney: Available at http://www.dpc.nsw.gov.au/__data/assets/pdf_file/0015/11490/interagency.pdf

NSW Department of Health. Policy guidelines for the management of patients with possible suicidal behaviour for NSW Health staff and staff in private health facilities. Sydney: NSW Department of Health Circular 92/31, 1998.

Pirkis J, Burgess P, Dunt D. Suicidal ideation and suicide attempts among Australian adults. Crisis 2000; 21: 16-25.

Steenkamp M, Harrison J. Suicide and hospitalised self-harm in Australia. Injury Research and Statistics Series. AIHW Catalogue no. INJCAT 30. Adelaide: Australian Institute of Health and Welfare, 2000.

Steenkamp M, Harrison J. Suicide and hospitalised self-harm in Australia. Injury Research and Statistics Series. AIHW Catalogue no. INJCAT 30. Adelaide: Australian Institute of Health and Welfare, 2000.

Australian Government of Health and Aged Care's suicide prevention information available at Suicide prevention, national suicide prevention strategy www.health.gov.au/internet/wcms/publishing.nsf/Content/mental-suicide and at Healthinsite www.healthinsite.gov.au/topics/Suicide_Prevention.

Print version with data

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Copyright notice

This work is copyright NSW Department of Health, 2006. It may be reproduced in whole or in part, subject to the inclusion of an acknowledgement of the source. Commercial usage or sale is prohibited.

Suggested citation

Population Health Division. The health of the people of New South Wales - Report of the Chief Health Officer. Sydney: NSW Department of Health. Available at: www.health.nsw.gov.au/publichealth/chorep/. Accessed (insert date of access).

Produced by

Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.

Last updated on 15 December 2008

Wordless Wednesday

The Internet and Self-Injury: What Psychotherapists Should Know

Abstract

The Internet affords information gathering and sharing previously impossible. For individuals who practice self-injury, this capacity allows rapid identification of others with shared history, experience, and practices. For many of those who self-injure, the ability to find others like themselves reduces the isolation and loneliness which so often characterizes the behavior.

For others, however, active participation in on-line communities may effectively substitute for the real work required to develop positive coping and healthy relationships. Our experience suggests that regular assessment of self-injury Internet use is uncommon in therapeutic settings. Proliferation of self-injury message boards, informational websites, blogs, and YouTube posts is a clinical challenge. In this article, we review the research on self-injury and Internet use and then make a series of recommendations for clinicians.

Read entire report here

Professional Help

What problems may be encountered when getting professional help?

Self-injury brings out many uncomfortable feelings in people who don't do it: revulsion, anger, fear, and distaste, to name a few. If a medical professional is unable to cope with her own feelings about self-harm, then she has an obligation to herself and to her client to find a practitioner willing to do this work. In addition, she has the responsibility to be certain the client understands that the referral is due to her own inability to deal with self-injury and not to any inadequacies in the client.

People who self-injure do generally do so because of an internal dynamic, and not in order to annoy, anger or irritate others. Their self-injury is a behavioral response to an emotional state, and is usually not done in order to frustrate caretakers.

What problems may be encountered in the emergency room?

In emergency rooms, people with self-inflicted wounds are often told directly and indirectly, that they are not as deserving of care as someone who has an accidental injury. They are treated badly by the same doctors who would not hesitate to do everything possible to preserve the life of an overweight, sedentary heart-attack patient.

Doctors in emergency rooms and urgent-care clinics should be sensitive to the needs of patients who come in to have self-inflicted wounds treated. If the patient is calm, denies suicidal intent, and has a history of self-inflicted violence, the doctor should treat the wounds as they would treat non-self-inflicted injuries. Refusing to give anesthesia for stitches, making disparaging remarks, and treating the patient as an inconvenient nuisance simply further the feelings of invalidation and unworthiness the self-injurer already feels.

Although offering mental health follow-up services is appropriate, psychological evaluations with an eye toward hospitalization should be avoided in the emergency room unless the person is clearly a danger to his/her own life or to others. In places where people know that self-inflicted injuries are liable to lead to mistreatment and lengthy psychological evaluations, they are much less likely to seek medical attention for their wounds and thus are at a higher risk for wound infections and other complications.

taken from Focus Adolescent Services

Why Does Self-injury Make Some People Feel Better?

• It reduces physiological and psychological tension rapidly.
  Studies have suggested that when people who self-injure get emotionally overwhelmed, an act of self-harm brings their levels of psychological and physiological tension and arousal back to a bearable baseline level almost immediately. In other words, they feel a strong uncomfortable emotion, don't know how to handle it (indeed, often do not have a name for it), and know that hurting themselves will reduce the emotional discomfort extremely quickly. They may still feel bad (or not), but they don't have that panicky jittery trapped feeling; it's a calm bad feeling.

• Some people never get a chance to learn how to cope effectively.
  One factor common to most people who self-injure, whether they were abused or not, is invalidation. They were taught at any early age that their interpretations of and feelings about the things around them were bad and wrong. They learned that certain feelings weren't allowed. In abusive homes, they may have been severely punished for expressing certain thoughts and feelings. At the same time, they had no good role models for coping. You can't learn to cope effectively with distress unless you grow up around people who are coping effectively with distress. Although a history of abuse is common about self-injurers, not everyone who self-injures was abused. Sometimes invalidation and lack of role models for coping are enough, especially if the person's brain chemistry has already primed them for choosing this sort of coping.

• Problems with neurotransmitters may play a role.
  Just as it's suspected that the way the brain uses serotonin may play a role in depression, so scientists think that problems in the serotonin system may predispose some people to self-injury by making them tend to be more aggressive and impulsive than most people. This tendency toward impulsive aggression, combined with a belief that their feelings are bad or wrong, can lead to the aggression being turned on the self. Of course, once this happens, the person harming himself learns that self-injury reduces his level of distress, and the cycle begins. Some researchers theorize that a desire to release endorphins, the body's natural painkillers, is involved.

• taken from: Focus Adolescent Services
  

Strength

How do you find strength when you have nothing left? I use quotes, things others have said I am honest and say 'I just cant do this'.

One of the signs that I am in 'trouble' is that I isolate, cut off friends, create petty arguments, wont answer phones etc I turn inward, I can go days without seeing people. At the time I most need people, I shut them out.

The Proverbial Wall...