to think these forms of self harm aren’t taken seriously

[busyweeks78]

I suffer with a mental health condition which means I often take overdoses. I’m always discharged home with little follow up. Aibu considering how dangerous this can be that they don’t put much support in place. This seems to vary from place to place though as I have a friend in another area who was sectioned for an overdose. Aibu to think that if people pose a significant risk that they should be sectioned? I’ve seen friends basically desperate to be admitted due to how unsafe they are.

Presumably if someone did really want to kill themselves they’d take enough of an overdose to achieve it and not repeated small overdoses?

Sadly my sibling died this way and had thoroughly researched how many tablets she needed to take.

Deliberate ingestion of poisonous substances is the most common form of self harm, more common than cutting.

But deliberate self harm alone isn’t classed as a mental health problem, so there is no reason to section someone for it.

If you want to stop doing it you need to find a counsellor who specialises in self harm, or read up on it through self help and put a harm reduction plan in place.

OP you may find this link useful for accessing community support.

www.england.nhs.uk/mental-health/adults/iapt/

I'm not quite sure what to suggest as a person who suffers MH with regular suicidal thoughts, but I can see how you are being portrayed as a time waster. You say you do it because you are overwhelmed with life.... However you are not taking enough to complete suicide. You need to find another outlet

I would agree that sometimes less intervention is better for patients but sadly I don’t think that decisions are being solely made on that criteria.

Why was my post deleted MNHQ?

Hi all,

We are very sorry but we don't allow discussion of method. We've taken advice from mental health charities such as mind, and as these results will come up on google results, we remove them.

We do hope you understand.

I think that appropriate community support should be available for patients with mental health problems. It is a travesty that there often isn’t the support that patients need.

I hesitate to use “attention seeking” to describe the type of deliberate self-harm you describe- and I do think this is probably the correct term (as opposed to suicide attempt)- because it is coming from a place of distress. However, it is not usually done with the intent to end life, more as a way of communicating distress to others or trying to “get away” from feelings of distress or being overwhelmed. Often, the physical harm is the trigger for care (of the physical injury or the assessment for potential physical damage of low level overdose)- as a junior doctor I remember well the “regular” patients who would admit that often it was the only time they felt anyone actually listened to them and felt they mattered. Which is very sad, and a poor reflection on the state of community support available.

However, each overdose is assessed on the intent and ongoing risk. Patients who actually intend to end their lives, have no remorse/are disappointed (or even angry) that they survived and admit/are thought to have ongoing intent will be deemed an immediate risk and offered voluntary admission or detained under the mental health act if they lack capacity/don’t consent to admission. The bar for being sectioned is set quite high (rightly, in my view).

It is also true that admitting/sectioning patients with certain conditions (euros/bpd, for example) often creates more issues than it solves- it can encourage maladaptive coping mechanisms (e.g. if I threaten to attempt suicide/low level self-harm then I will be admitted and have the ward as a safety blanket- again, have seen this as a junior doctor- very poor quality of life for that patient). But that’s not to say that NO help is needed- often DBT/psychological therapy is required. The issue can be that this is not easily accessible, or the help that is needed is not what the patient wants. Unfortunately, therapists and psychologists are in short supply and community mental health teams are stretched due to lack of staff/resources.

Euros= EUPD

When someone is sectioned they lose really important rights - they are essential imprisoned (albeit in a hospital) without having committed a crime and have no bodily autonomy. It is right that such a measure is reserved for the most serious cases.

I've suffered from poor mental health and used to self-harm. If that was grounds for sectioning I'd never have sought treatment.

Being voluntarily admitted is a totally different matter and, like community support, it all comes down to the fact that the money isn't there in the NHS to properly treat mental health problems.

Thank you everyone these some interesting view points

Can I ask what the overdoses do? I can kind of see that scratching could be a release type of feeling but dont really understand about overdoses? Is it to create (stomach?) pain or does it feel nice in some way or is it to go unconscious? Just curious and would like to understand.

I think it is such a lottery as to if you get help. I have EUPD and was sectioned a couple of years ago when I had a complete breakdown (included an overdose). I'm not sure why I was when others weren't but I was obviously considered a high risk.

I was kept on an acute ward for 7 months and then moved to a low secure PD unit. I have completed a year of DBT there and hoping to be discharged in a few months. DBT has really helped me. It is the best treatment for EUPD according to NICE.

The 'attention seeking' stigma needs to dissapear. Those with EUPD are at high risk of death due to over doses and other self-harm and it should be taken very seriously. Self-harm happens as the only way we have learnt to deal with distress and our extremely strong emotions. Unfortunately with the terrible funding for mental health the services are stretched very thin.

One of the criteria for getting a place at the PD unit was that you had to be motivated enough to commit to 18 months of treatment and really wanted to give it your best shot. I imagine with any service the more you can show that you really want to make changes in your life and will commit to the treatment programme the more likely you will be to get a place. Good luck and I hope things improve for you. A book I would reccomend is Stronger than BPD. It is a really validating and encouraging book and there is a journal with exercises too.

@gypsy - for me it was due to feeling completely overwhelmed with my emotions and that I just couldn't deal with life. Overdose happened because I just didn't know what else to do - it seemed my only option. It really is a desperate cry for help.

@spiderhunter - sectioning does not mean you have no bodily autonomy. The section refers to very specific things that can be done without your consent. You do not lose the right to give or withold consent in all ways.

@summeryet - I really don't get this 'less is more'. If the person already has an inability to cope then dependance on others is not really the issue. We need support to learn how to cope - to learn how to regulate our emotions, how to tolerate distress etc. We won't suddenly be able to cope by being denied access to mental health services in case we dare to depend on someone!

I have a young family member who is regularly In and out of psychiatric hospitals. There is a shortage of beds and sometimes when sectioned she is a couple of hours away from home.

She self harms most days when at home. Hair pulling, cutting, picking, scratching, self strangulation. She can't have anything sharp in her room and knives have to be hidden. It is only when she becomes a high suicide risk or a danger to others that she gets sectioned.

@Under Thanks for answering. That makes sense. Wish you all the best with the rest of your treatment.

I know someone who was sectioned recently and even then he was allowed to go in and out of the unit as he pleased though he was a serious risk to himself. Unmedicated still and it's been a few weeks now. He was made homeless in the meantime and they offered no help. The last I heard he was not getting the help he needed. Even being sectioned these days doesn't guarantee getting the help you need. The NHS is on its knees, it's failing constantly.

I self-harm in a typical way through cutting myself. I have been to A&E about 25-30 times in the last two years needing stitches (sometimes internal as well as external) but I have never been admitted, even when I have expressed I felt I was likely to do it again or have been several days in a row. So I don’t think it’s just your form of self-harm which doesn’t trigger a hospital admission. Mental health beds are in short supply and so if they don’t feel you’re at a serious risk of seriously harming yourself or others you’re unlikely to be admitted - somebody who self harms frequently but always seems out treatment afterwards and never does serious damage to themselves is not likely to be seen as a ‘significant’ risk by the mental health team, even if the self harm feels significant to you or your friends/ family.

Here you can admit yourself. Sectioning refers to an actual detaining where you don’t give consent.
Unfortunately (?) if you are deemed to be competent and have capacity you won’t be detained, I’m not sure what it is like where you are but as I say here you can admit yourself, and we tend to encourage people to do this rather than be sectioned and detained.
I’m sorry you’re self harming, I hope you feel better soon, I know from personal experience about self harm and I’ve broken bones before and knocked myself out (I won’t write here how I do it but I think you can guess) and I’ve also got experience with sectioning and detaining with work and honestly, it’s a totally different kettle of fish, theres more to your friends story than a single suicide attempt but try not to worry yourself about it. And please try to stop damaging yourself (I know that’s probably useless for me to say but worth a try 🙂)

Here you can admit yourself.

Most hospitals and units will have this facility. The big issue is the number of beds available.

I think we’re pretty lucky up here (north east England) in that we have 2 fantastic nhs hospitals very close by and another huge private one that takes nhs patients. We’ve never had a problem with people self admitting, especially with us behind them. I do feel for other places and people who aren’t so lucky :(

@gypsy - thank you