RCYBC: Representative highlights gaps in services for youth who self-injure
VICTORIA – Youth who engage in non-suicidal self-injuries (NSSI) need specialized and nuanced supports to address their complex needs and trauma, B.C.’s Representative for Children and Youth said today, adding that, despite the efforts of families, caregivers and professionals, too often these young people’s needs are not being met.
In her new report, A Way to Cope – Exploring non-suicidal self-injuries in B.C. youth, Jennifer Charlesworth expressed concern about a cohort of youth in B.C. receiving government services who repeatedly self-harm. The report paints a picture of these youth who engage in repeated and serious NSSI as often experiencing several injuries, carrying serious mental health diagnoses and having challenging family dynamics. It further reveals that NSSI is common and ranges in severity from scratches to wounds that require medical attention. In this report, the Representative explored severe NSSI for youth receiving government services.
A Way to Cope finds that NSSI is often a coping or regulation strategy for a young person. McCreary Centre Society’s 2018 BC Adolescent Health Survey found that youth self harm to: calm down; punish themselves; stop feeling numb; stop suicidal thoughts; to create a physical sign that one feels awful; to show others one’s pain; or to fit in with peers.
“Make no mistake: for young people engaging in non-suicidal self-injuries, NSSI is an emergency. This behaviour happens for complex reasons and is much more common than many people realize,” said Charlesworth. “Unfortunately, the outcomes can be devastating. Youth can end up in hospital and in some cases, they may die. Some youth have also ended up entering government care due to the complexity of their circumstances and to access services. The situation for these young people is urgent.”
The Representative examined aggregate data from 112 critical injury reports related to NSSI for 78 youth and, in addition, closely reviewed the files of five individual youth to illustrate how NSSI can manifest. More than three-quarters of those with one critical NSSI injury reported were in care at the time of their injury, but, of those with repeated NSSI injuries, more than 94 per cent were in care.
“What we’re seeing is that multiple services are involved in meeting the needs of youth who engage in NSSI, including MCFD, health authorities, school districts, non-profit agencies and private practitioners,” said Charlesworth. Those who care for and about them often struggle to address the needs within a system that lacks capacity to address complex needs.”
The report’s findings raise crucial questions that should be considered when shaping a response to this critical issue:
- Given the complexity of needs, why is there not a comprehensive model of care for youth with mental health challenges – such as those that predispose youth to NSSI – as there is for children and youth who receive services under MCFD’s specialized services for Children and Youth with Complex Care Needs (CYCCN)?
- Research has clearly shown that culture is a protective factor for youth. However practitioners were so focused on crisis reponse that they rarely considered culture in working with First Nations, Metis and Inuit youth engaging in NSSI. How can consideration of culture be embedded in practice?
- Research shows prevention of trauma or early intervention after trauma could prevent NSSI, and yet many of the young people experienced sexual violence and other traumas that were not addressed. When will full implementation of MCFD’s 2017 Trauma-Informed Practice Guide occur?
The report also speaks to how families and caregivers are deeply impacted when caring for a youth engaged in NSSI. Limited accessibility and intensity of supports and services available to caregivers of these youth may contribute to missed opportunities for prevention and early intervention.
“The bright spot that our research shows is that with effective supports, many – and perhaps most – youth are able to recover,” Charlesworth added. “What we need is to ensure those supports are ready for the families and young people when they are.”
The Representative expects the information contained within this report will induce government to take action and create needed systemic changes for young people. The report will function as a baseline with an anticipated follow-up in 2022 on services for children and youth who engage in NSSI..