What Teachers Should Know about Self-Mutilation and Suicide
Definition of Self-Mutilation
Self-mutilation, also known as self harm and self injury, is defined as any sort of self-harm that involves inflicting injury or pain on one’s own body. Sadly, over 10% of teenagers are suspected to have at least experimented with self-mutilation.
Although commonly defined as cutting, self-mutilation doesn’t take just one form. It can also include hair puling, hitting, bruising, biting, head banging, picking the skin, branding or burning the skin, or cutting the skin with a knife or razor until pain is felt or blood has been drawn. Self-mutilation is more often seen in upper to middle class adolescent girls and women.
Causes of Self-Mutilating Activity
There are a number of triggers that can lead someone to self injury. They include:
- low self-esteem
- inability to control impulses
- high levels of anger and anxiety
- apparent inability to cope with difficult situations
- underlying psychological conditions such as bipolar disorder or depression
- a tendency towards hyper-sensitivity
- feeling invisible or unaccepted by parents or peers
Signs of Self-mutilation
Signs that teachers and parents should be aware of include:
- razors, knives, or other sharp objects hidden in strange locations, evidence that a teenager’s friends are self-mutilating,
- long periods in restrooms, empty locker rooms or other secluded areas,
- a reduced social circle or reluctance to attend social events,
- reluctance to wear clothes that don’t hide legs and arms and the appearance of an abnormal amount of bruises or scars.
Prevention and Treatment of Self-Mutilation
There are several things that parents can do when their child has been discovered partaking in self injury. The most important thing is to not react with horror as most teens who struggle with self injury have low self esteem to begin with. It is important to spend time with your teen and make sure they don’t ever have the opportunity to feel invisible.
Teachers and administrators have a crucial role in the restoration of a child who self-mutilates. The best role for schools is to identify students who self-mutilate, refer them to and coordinate with community mental health resources, and offer safe, caring, and nonjudgmental support. It is also important to know your school procedures. Teachers and school administrators are mandatory reporters. Once identified, students are typically referred to the school nurse or mental health professional. Principals can help preserve students' physical and psychological welfare by improving awareness about the causes and signs of the behavior.
Unfortunately, self-mutilation appears to have a "contagious" effect among peer groups making it difficult to plan interventions and organize crisis teams. It may be helpful to formulate a student task force that advocates against self-mutilation among their peers, making it “cool” to not participate in self harm.
Suicide Statistics Amongst Teens
A common misconception is that those who self mutilate have the intention of committing suicide.Instead, often a student will self-mutilate in order to not commit suicide.However, suicide can be a result of self-mutilation and should not be overlooked.
Unfortunately, teen suicide is more prevalent of an issue than students should ever have to deal with.In fact, suicide is the third leading cause of death in 11-18 year olds in the nation.Among the suicides that were completed, 63% of the victims exhibited psychiatric symptoms for a year or more.For every completed suicide, an estimated 8 to 25 attempts have occurred.The most common methods to commit suicide include overdoses, hanging, and firearms.
Statistically there appears to be certain at risk groups.First are males.Only one female dies by suicide for every four males.Secondly, American Indians and Alaskan natives have the highest adolescent suicide rate followed by whites.Suicide is also the leading cause of death among gay and lesbian youth.The states with the highest suicide rates include Alaska, New Mexico and Montana.The West is the region that has the highest number of suicides while the Northeast has the lowest.
In Connecticut specifically, suicide is the second leading cause of death for 11-21 year olds.A study done in 2005 reported that within the past 12 months:
- 23% felt sad and hopeless enough over a two week period to halt usual activity.
- 13% thought seriously about suicide.
- 10% made a plan for suicide.
- And 3% made a suicide attempt that required medical attention. (For a secondary education teacher who may have 100 students between 4 or 5 classes, that number is startling, knowing that 3 of your students required medical attention because they attempted to kill themselves.)
Early and Late Warning Signs of Suicide
Early warning signs that teachers and parents should be on the lookout include:
- Withdrawal from friends and family
- Preoccupation with death
- Marked personality change and serious mood changes
- Difficulty concentrating
- Difficulties in school
- Change in eating and sleeping habits
- Loss of interest in pleasurable activities and things one cares about
- Frequent complaints about physical symptoms like stomach aches, fatigue, and head aches
- Persistent boredom
Late warning signs which usually take place just prior to the attempt include:
- Actually talking about suicide or a plan
- Exhibiting impulsivity such as violent actions, rebellious behavior and escape
- Refusing help
- Complaining about being a bad person
- Making statements about hopelessness, helplessness or worthlessness
- Not tolerating praise or rewards
- Giving verbal hints with statements
- Becoming suddenly cheerful after a period of depression
- Giving away favorite possessions
- Making a will
In order to prevent suicide and self-mutilation, schools need to be informed about the needs of their students and be aware of those students who are at risk. The important thing is to always keep your eyes opened. It is also important to adopt a bullying and harassment prevention program for all grades k-12, and to adopt a curriculum that does not promote hatred and bias. Many of the unfortunate adolescent suicides could have been prevented had bullying been prevented.
Resources and Additional Reading
- Understanding and Responding to Students Who Self-Mutilate
- Self-Mutilation in Adolescents, Catherine McDonald , CCRN, RN
- Cutting: Self-Injury Facts and Statistics, Scott Counseling
- Teen Self-Injury, Self-Mutilation, and Cutting, Troubled Teen 101
- Centers for Disease Control and Prevention. Suicide Prevention
- Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System
- State of Connecticut Office of Chief Medical Examiner. Suicide Statistics
- State of Connecticut Office of Child Advocate
- State of Connecticut Office of Health Care Access