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Working With Self Harm and Suicidal Behaviour

Working With Self Harm and Suicidal Behaviour

Louise Doyle | Brian Keogh | Jean Morrissey


Additional Information

Book Details


Suicide and self-harm are world-wide public health issues that can have devastating effects on families, friends and communities. They are both a priority for anyone working in mental health, social work, emergency departments and related fields, however suicidal and self-harming behaviour can take place anywhere anytime- it may be a pupil in a school, an inmate in a prison or a colleague or family member. For this reason, this book has been written in a clear, accessible and practical style for anyone who wants to learn more about working with and preventing suicidal and self-harming behaviour.
• It identifies common risk and protective factors as well as specific warning signs of imminent suicidal behaviour.
• It provides essential communication skills for undertaking a risk assessment, illustrating how each skill can be used in real-life practice.
• It looks specifically at the issue of self-harm and suicide in prisons, schools and emergency departments.
• It lays out clear strategies for identifying and addressing issues of self-care when working with people who are suicidal or who self-harm.
• It identifies how we can assist those who are bereaved following the death of a loved one by suicide.
Packed with learning outcomes, case scenarios and reflective questions, this book acts as a toolkit for anyone working in this difficult field.

"This book in my opinion is descriptive, informative and therefor useful to all healthcare professionals. The book is as the title says; about working with individuals who self-harm or have experienced/currently experiencing suicidal intent. Be it that they have attempted suicide or feel suicidal, it covers all you need to know, in order to work effectively with this client group. It explores in depth, how people who exhibit these behaviours feel, to what to look out for when workers come across service users, with a history of these behaviours. It explores in detail, the risks around working with or having a relative, friend or colleague who suffers with this unfortunate problem. It gives the reader a good biopsychosocial understanding of self-harm and suicidal behaviour and makes a good attempt at ensuring it is easily readable by all."

Jesse Wallen, community mental health nurse, Merton Drug & Alcohol Team

Louise Doyle is Lecturer in Mental Health Nursing, Trinity College Dublin, Ireland.

Brian Keogh is Lecturer in Mental Health Nursing, Trinity College Dublin, Ireland.

Jean Morrissey is Lecturer in Mental Health Nursing, Trinity College Dublin, Ireland.

Table of Contents

Section Title Page Action Price
Cover Cove
Contents v
List of Figures and Tables ix
Acknowledgements x
Introduction 1
1 Understanding Suicide and Self-Harm 5
Introduction 5
Defining suicide and self-harm 6
A theoretical understanding of suicide and self-harm 6
Biological perspectives 7
Psychological perspectives 10
Sociological perspectives 12
Stress, suicide and self-harm 14
Conclusion: An integrated approach to understanding suicide and self-harm 15
Reflective questions 16
2 Self-Harm, Suicide and Stigma 18
Introduction 18
What is stigma and how does it affect people? 18
Stigma and suicide 20
Why are suicide and self-harm stigmatised? 21
Addressing suicide stigma 22
Health professionals and other agencies 23
Suicide survivors and stigma 25
Helping individuals manage stigma 26
The role of the media and suicide and self-harm 27
Conclusion 27
Reflective questions 27
3 Risk and Protective Factors for Self-Harm and Suicide 29
Introduction 29
Risk factors for self-harm and suicidal behaviour 30
Protective factors for self-harm and suicidal behaviour 36
Warning signs of imminent suicidal behaviour 38
Conclusion 40
Reflective questions 40
4 Suicide and Self-Harm Across the Lifespan 43
Introduction 43
Self-harm and suicide in children 43
Self-harm and suicide in adolescents 44
Self-harm and suicide in early and middle adulthood 48
Self-harm and suicide in the older person 49
Conclusion 52
Reflective questions 52
5 Understanding and Responding to Self-Harm 56
Introduction 56
The language of self-harm 56
Self-harm: Epidemiology 59
Functions of self-harm 60
Responses to people who self-harm 62
Self-harm and recovery: Understanding and responding to the person 64
Therapeutic principles 65
Self-harm support groups and resources 67
Conclusion 68
Reflective questions 68
6 Communicating with People Who Are Suicidal 70
Introduction 70
Connecting with the suicidal person 70
Misconceptions and myths about suicide 71
Helpers’ responses to suicide 72
Establishing a helping relationship 73
Principles and characteristics of a helping relationship 74
Assessing the risk of suicide 77
Exploring the suicide question 79
Training 82
Conclusion 83
Reflective questions 84
7 Self-Care: Professional and Personal Considerations 86
Indroduction 86
Understanding self-care: What is it? 86
The workplace as a place of stress 88
Emotional labour 91
Compassion fatigue 92
Burnout 92
Impact of stress on the worker and organisation 93
Using self-care strategies in work 95
Beliefs about self-care 95
Self-care strategies and principles 96
Conclusion 99
Reflective questions 99
8 Suicide and Self-Harm Prevention and Reduction 101
Introduction 101
General population approaches 102
Targeted approaches 107
Reducing repetitive self-harm through harm reduction 110
The growth of online support for self-harm 111
Conclusion 113
Reflective questions 113
9 Postvention 117
Introduction 117
Who are suicide survivors and what is postvention? 118
Grief and complicated grief 118
The needs of people who have been bereaved by suicide 120
Peer support 122
The role of professional organisations 122
Responding to a suicide within a school or workplace 124
The role of the media 125
Conclusion 126
Reflective questions 126
10 Self-harm and Suicide in Prisons, Schools and Emergency Departments 129
Introduction 129
Self-harm and suicide in prisons 130
Self-harm and suicide in schools 133
Self-harm and suicide in the Emergency Department 137
Conclusion 140
Index 143