14 yo cutting herself- advice please MN

[nakedscientist]

My friend has called me, very distressed saying her DD has cut herself and she discovered it's not the first time. She will be going to the GP asap but does anyone know of good places to get advice and support?
How helpful are GPs regarding this issue?

She's a lovely girl and is a friend of my DD.

Can anyone help?

Self harm is generally, at its core a coping mechanism. It’s not normally suicidal.

The mum should just talk to, and listen to, her kid. In a calm manner. Work with her on better ways of coping with stress, and on ways to reduce harm. DONT get her to go cold turkey before she has better ways of coping, as you’ll leave her with no outlet then.

Going to GP is fine I guess. But self harm by itself doesn’t merit medical intention unless it’s deep and needing treating. And doesn’t normally merit referral to, say, CAMHS unless there’s evidence of mental illness (self harm is not, in itself, a mental illness).

They should figure out what is stressing her - school or friends or whatever - and work towards solving stresses too.

But the main thing is to be calm and supportive and containing.

Paddyfodder, I wouldn’t underestimate self harming as “not normally suicidal”. A significant number of my severely depressed and suicidal ECT patients started off with self harming, some still cutting themselves during treatment. I have a relative who self harmed as a young teen, and who had hanged herself twice by her early twenties and is lucky to be alive.
An urgent trip to the GP is advisable, for a proper psych assessment.

I’m a CAMHS consultant psychiatrist.

You’re seeing a very thin edge of the wedge there as you know.

DSH does obviously increase the risk of suicide, but in reality the aim of early intervention is to contain rather that escalate anxiety. Particularly as stress and anxiety are likely driving this.

You wouldn’t get a psych assessment for DSH in isolation; only if a decent suggestion of mental illness. And for that the parent and GP would need to talk to the child.

Really good info (and telephone support) at Young Minds charity:

youngminds.org.uk/find-help/feelings-and-symptoms/self-harm/

Thank you paddy and blue very, very much.

I have passed on the website and your comments. My friend was broken hearted last night.

In all honesty, she and her DH are lovely people but they have struggled as a couple, mainly due to my friends depression and the damage she suffered at the hands of a violent father. Her father has passed away and has had little or no influence directly on their child.

My eldest went through a spate of very serious self harm. In his case it was a symptom of a serious mental illness on top of a severe anxiety disorder that needed in-patient intervention. Thankfully most will not take it to the extremes my son did.
Young Minds is a helpful charity and I do recommend them. Appearing to stay calm and matter of fact, even when you might not feel that way, can help a teen to talk to you about how they may be feeling. More importantly knowing they can go to you could really matter if they ever did go a little too far and needed medical help for what they have done. MIND may also be able to signpost her to local reputable support around self-harm so it could be worth contacting them and asking. Your just being there with a cup of tea and a willingness to listen may all help her to support her daughter.

Camhs services differ around the country and where I am you would definitely be offered an assessment for self harm.

They should get a GP referral - there is likely to be a significant wait list, unfortunately.

In the mean time, the Mind website is very good, as is wellbeinginfo.org

My dd has been self harming recently an CAHMS recommended an app called Calm Harm. It s designed to teach the child to use other strategies to cope with their feelings.

Disappointing to hear that camhs provision is so patchy around the country. You and I are apparently lucky, Meantangerine, to live in areas where self harming is taken seriously and psych referral and help is readily available. My relative would have been dead without it, but is now stable on venlafaxine.
Paddyfodder, perhaps you should be lobbying for more resources in your area?

Thanks all. I have just texted my friend the recommendation of the calm harm app. It looks good.
She has used the young minds parents line today and said they were really helpful.
She has also organised a GP appointment this week.

The advice on here has been invaluable. I will do the tea and sympathy thing too to support her.

to those who have posted with their difficult stories.