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Self- harm, also known as self-injury, is when a person deliberately causes physical harm to themselves. Self-harming behaviour often takes place in secret and can therefore go on for a long time before it is noticed. The act is not usually intended to result in death but sometimes when a person self-harms (without meaning to end their life), they go too far and death results, this is called accidental suicide. If a person self-harms and does not receive help, they are likely to continue self-harming and are at an increased risk of accidental death or intentional death.
In Aboriginal and Torres Strait Islander communities, some cultural practices may be misread as self-harming behaviours. It is important that people working in the area of social and emotional wellbeing understand the differences between ‘ceremony’ or ‘sorry business’ and self-harm. For example, ‘sorry cuts’ are often practiced as a sign of grief for the loss of a family member. It is important that the warning signs for self-harm in individual communities are understood.
Self-harming behaviours can include:
People who self-harm usually find it hard to talk about their feelings; often they have not been taught how to cope with their emotions, so self-harm becomes a way of:
Some of the difficult situations people may find themselves in, which can lead to self-harming include:
People who self-harm often report feelings of hopelessness, anxiety, rejection, and low self-esteem. Other warning signs include:
The nature of self-harming behaviour, and the stigma and secrecy connected to it, makes it hard to get a true picture of how common it is among Aboriginal and Torres Strait Islander people. As a result of the social, emotional, and economic disadvantage faced by Aboriginal and Torres Strait Islander people, self-harm is more common among Indigenous people than it is among other Australians. In the period 2005 – 2007, Aboriginal and Torres Strait Islander people were hospitalised for intentional self-harm injuries at more than twice the rate of other Australians. It is important to remember that these figures are likely to underestimate how common self-harming is because not all self-harm injuries require hospitalisation; some injuries can be treated by a general practitioner or nurse at the local medical service and other injuries may not require any medical treatment.
It is very important to take self-harming behaviour seriously and not react in a negative way. Medical treatment may be required if there is a risk of permanent harm or death (for example, from an overdose of medication, eating or drinking toxic products, too much bleeding, or injuries to the eyes). If the self-harming behaviour is not life threatening, health workers should support the person to get specialised professional help; doctors, counsellors, or behavioural therapists may be able to help the person to cope with their feelings and emotions. Protective factors which can act as a buffer against self-harming behaviours include:
Auseinet (2004) Healing our way - self harm - a culturally appropriate resource for the Indigenous people of Yarrabah. Brisbane: FNQ Suicide Prevention Taskforce
Australian Institute of Health and Welfare (2010) Australia's health 2010: the twelfth biennial report of the Australian Institute of Health and Welfare. (AIHW Catalogue no AUS 122, Australia's health no. 12) Canberra: Australian Institute of Health and Welfare
Australian Institute of Health and Welfare (2009) Measuring the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples. (AIHW Catalogue no. IHW 24) Canberra: Australian Institute of Health and Welfare
Freeman D, Freeman B (2009) Aboriginal social and emotional wellbeing fact sheet series. Campbelltown, NSW: Campbelltown Community Mental Health Service (SSWAHS)
Living Is For Everyone (LIFE) (2007) Living is for everyone (LIFE) resources. Canberra: Living Is For Everyone (LIFE)
Mental Health First Aid Training and Research Program (2008) Suicidal thoughts and behaviours and deliberate self-injury: guidelines for providing mental health first aid to an Aboriginal or Torres Strait Islander person. Melbourne: Mental Health First Aid
Queensland Department of Communities (2008) Responding to people at risk of suicide: How can you and your organisation help? Brisbane: Queensland Department of Communities