Self-harm chat with Hannes 42nd Street
Hannes supports young people face to face and in groups at 42nd Street, an organisation committed to the needs of young people who self-harm. He came along to answer questions on getting help for the first time, telling a teacher, dealing with scars and occupational health checks.
Hannes: Hello everyone.
Anna: Hi Hannes.
MollyMiniature: Hi :)
Jo7: We're going to kick off with a question that came in from a user who couldn't make it to the chat.
She asked: How do you know when it's time to get help? Do I have to be ready to talk to start counseling or will they help me be able to talk?
Hannes: Good question there. It's a very personal thing to know when to get help, but it's really positive when you make the decision. Some counseling and support services will work specifically around self-harm and will be aware it's a really difficult thing to start talking about. If you're nervous about talking to someone face to face, you could practice what you'd like to say by writing it down or you could phone a helpline such as the Bristol Crisis service for women. The number is 01179 2511119.
That might ease you into being able to talk about your difficulties. Or, perhaps there's a friend, youth worker or someone who supports you already, who could come with you for your first appointment for moral support.
In terms of knowing if it's the right time to go - the fact you've already asked this question suggests you are already thinking about getting support which also suggests you're ready to start dealing with the issues. If you find that when you do speak to someone that you don't get on with them or get the response you're expecting, don't be disheartened as you can look for support elsewhere.
MollyMiniature: If you told someone at school (like a teacher) that you self harm, would they have to tell your parents?
Hannes: Thanks for your question MollyMiniature, how old are you?
MollyMiniature: I'm 16.
Hannes: At the age of 16 or 17 some aspects of the law view you as an adult and so when you access a service you should be treated as an adult. That means that in most circumstances you have a right to confidentiality. However, different schools have different policies sometimes and some feel that if there's a significant risk it's their duty to inform your parents or GP.
You'd be perfectly within your rights to ask what your schools confidentiality policy is. If they have counseling services or a pastoral team this should be made readily available and you won't have to explain why you need it.
A counsellor at school will be working to the guidelines of the school and they would probably make a decision as to whether anyone else needs to be involved based on the level of risk there is in your particular situation.
Hannes: Does that all make sense?
MollyMiniature: Yes, thank you.
Anna: Is there a way that you can become more in control of your self-harm? I remember doing it as early as about seven or eight years-old, and am now 21. At times I've felt that I am OK to just do it once every two weeks (ish) and I was able to give myself a set amount that I was allowed to do.
Now, it's just out of control. I have been seeing a social worker for talking therapy for over two years and I have been on medications for most of this time for a range of mental health conditions.
Hannes: Hi Anna, thanks for your question. Have you been able to be honest with your social worker about how things are getting out of control?
It's really great that in the past you've been able to put some limits and boundaries around your self-harm and perhaps it's important to focus on why you were successful in the past and what worked.
Anna: Yes, he knows exactly what is going on, they are putting me back on medication soon. I just didn't have the urges as much beforehand.
Hannes: Perhaps there were particular techniques you used in the past when you had the urge to self-harm? Or, perhaps there are things going on in your life at the moment or painful memories or experiences that you're finding it difficult to cope with?
Anna: Yes.
Hannes: You could ask your social worker if there are other services that could support you. That could help you to explore further the difficult feelings and emotions you're experiencing.
Sometimes people might advise you on using distraction techniques such as keeping a diary of difficult feelings or having a set of questions you ask yourself when you're feeling the urge such as "how did I feel the last time I hurt myself?" or "how would I feel if I didn't hurt myself?"
Anna: I have had to move away, and so I wont be able to stay in that service. So far I have chosen not to get in contact with any services when I get to my new place, but maybe that's the wrong decision with how things are going now.
Hannes: The important thing is to get as much support as you feel is necessary and to not give yourself a hard time about the frequency of self-harm; that can perpetuate the guilt and bad feelings that lead you to self-harm in the first place.
Anna: Yes, that is definitely true for me.
Hannes: It's totally up to you what you decide to do, but going into a new situation might add stress and it might be really important to have a support network available for when you arrive. A social worker might be able to make links with local projects specifically around self-harm for you. Contacting the national self-harm network could be a good idea too, take good care of yourself.
Anna: Yeah, I think I will contact my social worker and see whats available, thanks.
junie: I have been self-harming for a long time now and dont know how I can stop, please help me.
Hannes: Hi Junie, thanks for coming to this chat. It's excellent that you're looking to find ways to manage your self-harm. This is by far the biggest and most positive step.
The decision to stop often comes a long time before successfully stopping altogether. At first it might be thinking about how to manage self-harm looking at the causes and root behind your self-harm, putting other coping strategies in place.
Self-harm is usually a reaction to distressing or painful life circumstances and people often consider it their only way to cope, but seeking support from someone who has experience can help to release some of the pressure.
junie: Is there a way I can talk to someone without having to talk face to face?
Hannes: How old are you Junie?
junie: Im 20.
Hannes: There are helplines that you could call and in some areas there can be local web-based therapeutic services that you might be able to find out about through the NHS.
ella256: You can phone hotlines like Samaritans too (08457 909090).
"Self-harm is usually a reaction to distressing or painful life circumstances and people often consider it their only way to cope, but seeking support from someone who has experience can help to release some of the pressure."
Hannes: Most people who are just starting out in getting help find helplines a really effective way to start the process. As I mentioned earlier, you can also try Bristol Crisis Service for women (01179 2511119).
You might also like to try buslist.org which is a worldwide organisation that has resources and discussion forums specifically related to self-harm. Recoveryourlife.com is a support community which you may also find helpful. I hope you find some of these suggestions work for you.
junie: OK, thanks.
kermit: When I was younger I self-harmed a lot and still have the scars on my arms and chest. They've gone white now but they stay white when I tan. Is there anything you can think of to make the scars less noticeable?
Hannes: Hi Kermit, thanks for the question. A lot of people who self-harm feel really worried about the visibility of scars. Some people use cosmetic cover-up creams, but obviously that's just temporary. There are longer lasting treatments, such as laser treatment or cosmetic surgery, which often have risks attached to them so should always be discussed with a specialist. However, in some cases these can make scars look worse.
Flo: I wear lots of bracelets on my arm, not only do they cover up but they look good. I have lots of bracelets that mean something to me and remind me of the friends I have if I am tempted to self-harm.
Hannes: You could also visit your GP or pharmacist and ask about scar reduction creams. Some people use bio oil but it doesn't work for everybody.
kermit: I know I wouldn't want cosmetic surgery. It's normally only a problem in hot weather, when I cant wear long sleeves.
Hannes: Some chemists sell silicone gel sheets that some people put over their scars to reduce redness - but that's for fairly more recent scars.
kermit: Some of these scars are ten years old. Unfortunately I liked picking at them rather than using bio-oil to reduce them, but that answers my question quite well, thank you.
Hannes: Maybe it's also helpful to remember that although you don't like your scars, they're a result of your experience and all of your experiences make up who you are. The fact you haven't self-harmed for a long time is such an achievement. Be proud of that and try not to feel ashamed of your scars.
kermit: I think the only issue I have is professional. I'm working with vulnerable young people and don't want them to see the scars. Looks like I'll just have to melt!
Anna: It might not be a negative if they saw though; it might make them more likely to open up to you.
Hannes: That's a really good point Anna. The British Red Cross also provide free camouflage creams to people and show you how to put them on, might be worth contacting them to see what's available.
Flo: I think its great that you are doing something so positive in response to your experiences.
Hannes: Yeah, definitely.
ella256: Does anyone know if having a previous history of mental illness can affect your eligibility for university courses in medicine or nursing?
Hannes: Hi ella, another good question. It really depends on your own individual circumstances. When you enter any service profession e.g. nursing/police, the application process involves an occupational health screening that asks you questions about any health problems including mental health questions. Theyd also contact your GP for medical history who would verify your answers to the questions.
This doesn't necessary stop you from entering though. Certain things would be taken into consideration such as how long ago the problems were and what coping mechanisms you use when you're dealing with difficult circumstances.
Anna: In my experience it has meant more occupational health checks, but it doesn't stop you.
Hannes: There are lots and lots of people working within the NHS who have been open about self-harming in the past and they're able to carry on with their careers perfectly well.
ella256: I dont know if Id pass an Occupational Health screening.
Hannes: You could anonymously contact a college or recruitment helpline for the NHS and ask them about their recruitment procedure relating to health.
Flo: Does it affect any other professions?
Hannes: It's usually professions when you're delivering services to the public. Some businesses and private organisations also have occupational health checks, but the main ones are teaching, police, NHS and civil service.
kermit: You would need to show that you can remain professional and that you're well enough to cope with the stresses of the job, but you can work in that field with a history of mental health difficulties. If you're still experiencing mental health difficulties, if you're still self-harming, it can be harder. It can also affect the law, if you want to be a solicitor or barrister, but it's just the same checks.
Anna: I've now qualified as a health care professional (awaiting registration though) and I have been totally honest about still self-harming, having six mental health conditions, a few times beeing in hospital, and have still got my first newly qualified job. Not saying it's that easy for everyone, but self-harming alone shouldn't stop you.
Flo: Congratulations Anna.
Anna: Thanks :)
kermit: It hasn't stopped me either. It is possible to move on and build a decent life.
Hannes: That's a really good example Anna of how these professions have changed over the last ten years as there's much more understanding and support.
junie: If someone found out I self-harmed at work could they stop me working in a nursery?
Hannes: Things like that have happened in the past junie, but it really depends on the organization. If you did feel there was any discrimination or lack of understanding then it would be important to take legal advice. Unless you feel you need support from your employers, there's nothing forcing you to tell them about your self-harm.
junie: OK, thanks.
Flo: Do pre-18 medical records get included in Occupational Health checks?
Hannes Yes, it's your whole medical health history including childhood illnesses.
Flo: Thank you so much.
Hannes Thanks for all the questions guys.
Jo7: Thanks everyone, sorry we dont have more time. Hannes is also one of the advisors working on askTheSite so you can ask a question there or post about anything that is troubling you on our discussion boards.
Self-harm chat with Hannes 42nd Street
Hannes supports young people face to face and in groups at 42nd Street, an organisation committed to the needs of young people who self-harm. He came along to answer questions on getting help for the first time, telling a teacher, dealing with scars and occupational health checks.
Hannes: Hello everyone.
Anna: Hi Hannes.
MollyMiniature: Hi :)
Jo7: We're going to kick off with a question that came in from a user who couldn't make it to the chat.
She asked: How do you know when it's time to get help? Do I have to be ready to talk to start counseling or will they help me be able to talk?
Hannes: Good question there. It's a very personal thing to know when to get help, but it's really positive when you make the decision. Some counseling and support services will work specifically around self-harm and will be aware it's a really difficult thing to start talking about. If you're nervous about talking to someone face to face, you could practice what you'd like to say by writing it down or you could phone a helpline such as the Bristol Crisis service for women. The number is 01179 2511119.
That might ease you into being able to talk about your difficulties. Or, perhaps there's a friend, youth worker or someone who supports you already, who could come with you for your first appointment for moral support.
In terms of knowing if it's the right time to go - the fact you've already asked this question suggests you are already thinking about getting support which also suggests you're ready to start dealing with the issues. If you find that when you do speak to someone that you don't get on with them or get the response you're expecting, don't be disheartened as you can look for support elsewhere.
MollyMiniature: If you told someone at school (like a teacher) that you self harm, would they have to tell your parents?
Hannes: Thanks for your question MollyMiniature, how old are you?
MollyMiniature: I'm 16.
Hannes: At the age of 16 or 17 some aspects of the law view you as an adult and so when you access a service you should be treated as an adult. That means that in most circumstances you have a right to confidentiality. However, different schools have different policies sometimes and some feel that if there's a significant risk it's their duty to inform your parents or GP.
You'd be perfectly within your rights to ask what your schools confidentiality policy is. If they have counseling services or a pastoral team this should be made readily available and you won't have to explain why you need it.
A counsellor at school will be working to the guidelines of the school and they would probably make a decision as to whether anyone else needs to be involved based on the level of risk there is in your particular situation.
Hannes: Does that all make sense?
MollyMiniature: Yes, thank you.
Anna: Is there a way that you can become more in control of your self-harm? I remember doing it as early as about seven or eight years-old, and am now 21. At times I've felt that I am OK to just do it once every two weeks (ish) and I was able to give myself a set amount that I was allowed to do.
Now, it's just out of control. I have been seeing a social worker for talking therapy for over two years and I have been on medications for most of this time for a range of mental health conditions.
Hannes: Hi Anna, thanks for your question. Have you been able to be honest with your social worker about how things are getting out of control?
It's really great that in the past you've been able to put some limits and boundaries around your self-harm and perhaps it's important to focus on why you were successful in the past and what worked.
Anna: Yes, he knows exactly what is going on, they are putting me back on medication soon. I just didn't have the urges as much beforehand.
Hannes: Perhaps there were particular techniques you used in the past when you had the urge to self-harm? Or, perhaps there are things going on in your life at the moment or painful memories or experiences that you're finding it difficult to cope with?
Anna: Yes.
Hannes: You could ask your social worker if there are other services that could support you. That could help you to explore further the difficult feelings and emotions you're experiencing.
Sometimes people might advise you on using distraction techniques such as keeping a diary of difficult feelings or having a set of questions you ask yourself when you're feeling the urge such as "how did I feel the last time I hurt myself?" or "how would I feel if I didn't hurt myself?"
Anna: I have had to move away, and so I wont be able to stay in that service. So far I have chosen not to get in contact with any services when I get to my new place, but maybe that's the wrong decision with how things are going now.
Hannes: The important thing is to get as much support as you feel is necessary and to not give yourself a hard time about the frequency of self-harm; that can perpetuate the guilt and bad feelings that lead you to self-harm in the first place.
Anna: Yes, that is definitely true for me.
Hannes: It's totally up to you what you decide to do, but going into a new situation might add stress and it might be really important to have a support network available for when you arrive. A social worker might be able to make links with local projects specifically around self-harm for you. Contacting the national self-harm network could be a good idea too, take good care of yourself.
Anna: Yeah, I think I will contact my social worker and see whats available, thanks.
junie: I have been self-harming for a long time now and dont know how I can stop, please help me.
Hannes: Hi Junie, thanks for coming to this chat. It's excellent that you're looking to find ways to manage your self-harm. This is by far the biggest and most positive step.
The decision to stop often comes a long time before successfully stopping altogether. At first it might be thinking about how to manage self-harm looking at the causes and root behind your self-harm, putting other coping strategies in place.
Self-harm is usually a reaction to distressing or painful life circumstances and people often consider it their only way to cope, but seeking support from someone who has experience can help to release some of the pressure.
junie: Is there a way I can talk to someone without having to talk face to face?
Hannes: How old are you Junie?
junie: Im 20.
Hannes: There are helplines that you could call and in some areas there can be local web-based therapeutic services that you might be able to find out about through the NHS.
ella256: You can phone hotlines like Samaritans too (08457 909090).
Hannes: Most people who are just starting out in getting help find helplines a really effective way to start the process. As I mentioned earlier, you can also try Bristol Crisis Service for women (01179 2511119).
You might also like to try buslist.org which is a worldwide organisation that has resources and discussion forums specifically related to self-harm. Recoveryourlife.com is a support community which you may also find helpful. I hope you find some of these suggestions work for you.
junie: OK, thanks.
kermit: When I was younger I self-harmed a lot and still have the scars on my arms and chest. They've gone white now but they stay white when I tan. Is there anything you can think of to make the scars less noticeable?
Hannes: Hi Kermit, thanks for the question. A lot of people who self-harm feel really worried about the visibility of scars. Some people use cosmetic cover-up creams, but obviously that's just temporary. There are longer lasting treatments, such as laser treatment or cosmetic surgery, which often have risks attached to them so should always be discussed with a specialist. However, in some cases these can make scars look worse.
Flo: I wear lots of bracelets on my arm, not only do they cover up but they look good. I have lots of bracelets that mean something to me and remind me of the friends I have if I am tempted to self-harm.
Hannes: You could also visit your GP or pharmacist and ask about scar reduction creams. Some people use bio oil but it doesn't work for everybody.
kermit: I know I wouldn't want cosmetic surgery. It's normally only a problem in hot weather, when I cant wear long sleeves.
Hannes: Some chemists sell silicone gel sheets that some people put over their scars to reduce redness - but that's for fairly more recent scars.
kermit: Some of these scars are ten years old. Unfortunately I liked picking at them rather than using bio-oil to reduce them, but that answers my question quite well, thank you.
Hannes: Maybe it's also helpful to remember that although you don't like your scars, they're a result of your experience and all of your experiences make up who you are. The fact you haven't self-harmed for a long time is such an achievement. Be proud of that and try not to feel ashamed of your scars.
kermit: I think the only issue I have is professional. I'm working with vulnerable young people and don't want them to see the scars. Looks like I'll just have to melt!
Anna: It might not be a negative if they saw though; it might make them more likely to open up to you.
Hannes: That's a really good point Anna. The British Red Cross also provide free camouflage creams to people and show you how to put them on, might be worth contacting them to see what's available.
Flo: I think its great that you are doing something so positive in response to your experiences.
Hannes: Yeah, definitely.
ella256: Does anyone know if having a previous history of mental illness can affect your eligibility for university courses in medicine or nursing?
Hannes: Hi ella, another good question. It really depends on your own individual circumstances. When you enter any service profession e.g. nursing/police, the application process involves an occupational health screening that asks you questions about any health problems including mental health questions. Theyd also contact your GP for medical history who would verify your answers to the questions.
This doesn't necessary stop you from entering though. Certain things would be taken into consideration such as how long ago the problems were and what coping mechanisms you use when you're dealing with difficult circumstances.
Anna: In my experience it has meant more occupational health checks, but it doesn't stop you.
Hannes: There are lots and lots of people working within the NHS who have been open about self-harming in the past and they're able to carry on with their careers perfectly well.
ella256: I dont know if Id pass an Occupational Health screening.
Hannes: You could anonymously contact a college or recruitment helpline for the NHS and ask them about their recruitment procedure relating to health.
Flo: Does it affect any other professions?
Hannes: It's usually professions when you're delivering services to the public. Some businesses and private organisations also have occupational health checks, but the main ones are teaching, police, NHS and civil service.
kermit: You would need to show that you can remain professional and that you're well enough to cope with the stresses of the job, but you can work in that field with a history of mental health difficulties. If you're still experiencing mental health difficulties, if you're still self-harming, it can be harder. It can also affect the law, if you want to be a solicitor or barrister, but it's just the same checks.
Anna: I've now qualified as a health care professional (awaiting registration though) and I have been totally honest about still self-harming, having six mental health conditions, a few times beeing in hospital, and have still got my first newly qualified job. Not saying it's that easy for everyone, but self-harming alone shouldn't stop you.
Flo: Congratulations Anna.
Anna: Thanks :)
kermit: It hasn't stopped me either. It is possible to move on and build a decent life.
Hannes: That's a really good example Anna of how these professions have changed over the last ten years as there's much more understanding and support.
junie: If someone found out I self-harmed at work could they stop me working in a nursery?
Hannes: Things like that have happened in the past junie, but it really depends on the organization. If you did feel there was any discrimination or lack of understanding then it would be important to take legal advice. Unless you feel you need support from your employers, there's nothing forcing you to tell them about your self-harm.
junie: OK, thanks.
Flo: Do pre-18 medical records get included in Occupational Health checks?
Hannes Yes, it's your whole medical health history including childhood illnesses.
Flo: Thank you so much.
Hannes Thanks for all the questions guys.
Jo7: Thanks everyone, sorry we dont have more time. Hannes is also one of the advisors working on askTheSite so you can ask a question there or post about anything that is troubling you on our discussion boards.