Self-harm

Citation

(2009), "Self-harm", Health Education, Vol. 109 No. 5. https://doi.org/10.1108/he.2009.142109eag.001

Self-harm

Article Type: Internet review From: Health Education, Volume 109, Issue 5

Self-harm or self injury can take many different forms. Cutting the arms and legs is very common amongst self-harmers, but the injuries may also be caused through drugs, burns, swallowing objects and even self-strangulation. Self-harm is more common in the young and peaks between the ages of 20-24 for men and 15-19 for women. Divorce and being single increase the likelihood of self-harm as does being unemployed. Up to one-third of people who self-harm will do so again within a year if they do not get any help or support, and people who self-harm are 50 times more likely to commit suicide. Treatment for self-harm will often involve psychotherapy of various forms, e.g. counselling, psychodynamic therapy or cognitive behaviour therapy (CBT), although drug treatment may also be used. In addition to these therapies, people who self-harm need the support of others and this may come in the form of self-help groups where people can share their problems with others who will understand them. Self-help can also take other forms, for example health education and it is here that the internet may be able to help.

The Site

www.thesite.org/healthandwellbeing/mentalhealth/selfharm

The Site.org is a health and well-being website aimed specifically at young people and this is reflected in both the design and the content. There is so much content in this web site that it may be a litle difficult to know where to start. The section dealing with “What is self-harm” constitutes the main part of the home web page and this link takes the user to a short text-based page that explains the basics of self-harm. The article discusses the various forms that self-harm can take, its relationship with suicide, as well as the possibility that self-harm may be a form of personality disorder. For young people who can’t be bothered to read the text, there is also a very good video clip in which a senior mental health practitioner talks about how she defines self-harm and what services are available for young people. The website also has interactive discussion boards, which I guess would be one of the most important features of this website. There is also an archive of questions posted by users that is also very informative.

Perhaps the only criticism that might be made of this website is that there is almost too much information. The organisation of the content is a little mixed, sometimes driven by images other times it seems to be mainly text-based, and this can be confusing. However, despite this the website does represent an excellent resource for both young people as well as health education professionals.

Wikipedia

http://en.wikipedia.org/wiki/Self-harm

Wikipedia is an online encylopeadia whose content is provided and maintained by its users. As it grows and develops Wikipedia is finding its way more and more into the results of search engines like Google. This is both good news and bad news. Although Wikipedia is moderated to some extent, most of the content is provided by lay people who may or may not be qualified to comment on a particular topic. For this reason users must be circumspect in using this resource, particularly as there is no indication as to authorship of the content.

The overall design of websites in Wikipedia is largely determined by the Wikipedia format and this means the content is in the main text-based with little or no interactivity. The content provided here is good with the information on definitions and demographics of self-harm being quite comprehensive, as well as UK-focused. The material dealing with psychological explanations of self-harm is perhaps a litle more controversial but a note by the moderators makes the user aware of this and indeed invites further contributions to this section.

The list of treatments discussed, while not extensive, does include all the main forms ranging from drug treatments, behaviour therapy and psychotherapy in its various forms.

For academics and health professionals the further readings and references sections will be particularly useful as might the podcasts provided by BBC Radio 4.

One of the strengths of Wikipedia websites is also one of its main irritations. For academic users the number of links to related topics and further references is a boon, but for the lay person they quickly become a distraction that can whisk you away from the main topic of interest. As a lay user of Wikipedia a person has to learn to focus determidly on their choice of topic and resist the temptations of the many links provided.

As a health education resource, Wikipedia is going to become increasingly important and it might therefore be useful if health education professionals considered making contributions to topics for which they feel qualfied.

Self-harm

www.selfharm.net/

This website, according to its own statistics, was last updated in December 2002, but despite being dated, it does have some interesting features that are worth a look. The design reflects the time when this website was first developed and therefore is largely text-driven and presented in a listing format. In terms of definitions, aetiology and treatment the content presented here is much as you might find elsewhere, though here it is probably far more detailed than provided by other web sites.

One section that will be of particular interest to many users deals with Self-Help. This is extremely detailed and provides many suggstions and activities than can be used by people who self-harm, to help themselves. It is acknowledged that these “substitution” activities may or may not work for different people, but given the variety of activities suggested, most people will probably find something that can help. For those who fail to find help here, there is a section that deals with first aid specifically for the types of self-inflicted injuries that are likely to be experienced.

The hidden sufferers in these types of situations are of course the family and friends of those who self-harm. This is an area that is sometimes forgotten but this web site deals with this issue well and provides supportive information and links that will be of help to those that need it.

One novel feature of this website is the “Assessing your immediate need to self-injure” section. For a person who has a strong need to self-harm, this part of the web site is meant to act as a form of self-therapy. The user is asked for their e-mail address and is then presented with a number of text boxes, each with an associated question, for example “Why do I feel I need to hurt myself?”, or “How will I feel after hurting myself?”, and finishing with “Do I need to hurt myself?”, eight questions in all. After responding to each of the questions, and hitting the submit button, the text is e-mailed to the user’s e-mail account. The assumption is that the user (self-harmer) will review their answers and therefore question their own motives and behaviours, before (or instead of) injuring themselves. Unfortunately, at the time of writing, this feature wasn’t working properly and the responses weren’t e-mailed; nevertheless, the very act of completing the text boxes probably would have some therapeutic benefit.

The content and features of this website are very interesting and should be preserved. However, it needs a thorough makeover to bring it up-to-date with what the modern internet can provide.

Channel 4

www.channel4.com/health/microsites/0-9/4health/mind/wwr_selfharm.html

Channel 4, the television station, provides what it calls “microsites”, i.e. small websites that deal with a variety of issues including health and well-being, and this particular microsite is looking at the mind, or more specifically mental health and in this case, self-harm. In terms of resources, interactivity and design, this website could probably be considered as “leading edge”, though inevitably this means that the content provided is supported by advertisements which in this case, annoyingly, occupy a third of the users screen.

The information that is presented to the user via these microsites is in fact very similar to the previous website in that it is almost wholly text-based. The content begins with a review of the demographics of self-harm as well as considering aetiology and treatment. The section on “Myths about Self-Harm” is original and quickly dismisses the notions of attention-seeking and would-be suicide. An overview of professional help is provided but this is rather superficial and links to more detailed information sources would be useful. For some reason there is a link to art therapy, but nothing for the more conventional therapies.

The self-help section provides useful guidance for those who might be at risk, as well as their friends and families. There are also links to organisations that may be able to offer help, for example the Samaritans and the National Self-Harm Network. Unfortunately at the time when this review was being written, the website for the National Self-Harm Network was being revamped and was therefore not available. Finally a brief reading list is provided but given that the most recent title was published in 2000, users might want to do their own research if they want to read something a little more up to date.