Suicide and Self-harm - The Challenge for Front line Staff

Jones, Kerry and Mallon, Sharon (2018). Suicide and Self-harm - The Challenge for Front line Staff. In: Suicide & Self Harm – The Challenge for Front Line Staff, 21 Jun 2018, UNISON Belfast, Northern Ireland, UK.


Presentation with suicidal ideation is a key opportunity to engage with people. The needs of this vulnerable group and their fears about presenting with suicide and self-harm is poorly understood. From research I have undertaken participants have reported avoiding A and E wherever possible. When they do, they do so with feelings of shame and unworthiness. These feelings have reportedly been reinforced with what they people perceive as punitive treatment perpetuating a cycle of shame, avoidance and further self-harm and suicide (Owens, example if needs be). Positive encounters on the other hand mirrored situations in the care received was delivered with compassion which had the potential to challenge negative self-evaluation.

Definitions: An internationally agreed definition.

Self harm: “An act with non-fatal outcome in which an individual deliberately initiates a non-habitual behaviour, that without intervention from others will cause self-harm, and which is aimed at realising changes that the person desires via the actual expected physical consequences.”

Suicidal ideation: “Acts of suicidal ideation include presentation to the ED by persons who have experienced thoughts of self-harm and, or suicide, where no physical act to harm oneself has taken place.”

Knowledge exchange seminar series (2015-2016) Queen’s University Belfast, The Open University, Ulster University.

While we know there are certain ages and groups of people at particular risk, my focus here today is on young people.

What are some of the things that drive people to think about suicide or engage in self-harm?

* Personal catastrophes such as being made redundant, break up of a relationship, grief, conflict within the home or members of the community.
* A persistent sense of worthlessness or failure, uncertainty about sexual identity or personal goals
* Ideas about successful life goals which they see other people doing such as getting married, going to university, getting new jobs, house etc. and being left behind.
* A combination of all the above together with a series of setbacks which can be devastating.

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