Kelty Mental Health
This excellent website for youth, families and professionals looking for information on child and youth mental health issues has a wide range of information and is  user friendly in its formatting.  Browse or search for areas of interest.
(https://keltymentalhealth.ca/)

Here to Help
This is a BC information resource for individuals and families managing mental health issues and/or substance abuse. You’ll find some great articles, along with personal stories on this useful site. There is a also an entire page devoted to family members, with information on how to support someone experiencing  a mental health issue. (http://www.heretohelp.bc.ca/)

Teen Mental Health
There are many useful resources on this interactive site dedicated to helping improve the mental health of youth through the translation and transfer of scientific knowledge. (http://teenmentalhealth.org/)

Mind Your Mind
Mindyourmind.ca is an award winning creative site for youth by youth. This is a place where you can get info, resources and the tools to help  manage stress, crisis and mental health problems.  There are other interesting links as well covering a range of interesting issues not necessarily specific to  mental health but enriching  information for youth, families etc.  (http://www.mindyourmind.ca/)

Anxiety Canada
The Anxiety Disorder Association of British Columbia is a non-profit organization which was started in early spring of 1999 by a group of concerned consumers, family members, and professionals, who work to increase awareness about anxiety disorders; promote education of the general public, affected persons, and health care providers; and increase access to evidence-based resources and treatments. Visit their pages on Self-Help, as well as their page for Parents and Caregivers. (http://www.anxietybc.com/)

Dealing with Depression Workbook: “Antidepressant Skills for Teens”

This pdf is available to download and can be a helpful tool to work with teens or for teens to browse to consider what they might understand better if depression has been a key concern.  This workbook has been produced by mental health professionals in British Columbia and provides some basics around the introduction and  use of cognitive behavioural therapy. (http://www.comh.ca/publications/resources/dwd/DWD_PrintVersion.pdf)

Mood Disorders Society of Canada

This is the website of the mood disorders association of Canada and provides some information on the diagnosis of mood disorders, as well as advocacy for those with mood disorders. (https://mdsc.ca/)

Canadian Mental Health Association
The Canadian Mental Health Association is a nation-wide, charitable organization that promotes the mental health of all and supports the resilience and recovery of people experiencing mental health issues.  (http://www.cmha.ca/)

Welcome to our page for professionals! This page is to link professionals with other websites that contain current information about self-injury in youth. There is general information, information for school professionals and other professionals. Specific resources also include the Self Assessment Sheet for those working with youth who self injure and the Ottawa Self Injury Inventory (OSI), and Functions only version of the OSI. Recent evaluation research publications on the OSI are provided for those interested.

General Information for Professionals

Information for School Professionals

Information for Mental Health Clinicians and other Helping Professionals/Physicians

Publications on the Ottawa Self-Injury Inventory

Psychometric properties of the functions and addictive features scales of the Ottawa Self-Injury Inventory: a preliminary investigation using a unive… – PubMed – NCBI 2013

The Ottawa Self-Injury Inventory: Evaluation of an assessment measure of nonsuicidal self-injury in an inpatient sample of adolescents. 2015

A psychometric analysis of the Ottawa self-injury inventory-f: Journal of American College Health: Vol 66, No 1 2017

Welcome to our Family and Friends page. This page is to help family members and friends of youth who self-injure find good information about self-injury.

As a friend or family member, what can you do?

There is an important role that family members and friends can play with youth who are willing to disclose about their self-injury. Firstly, the ability to listen and understand from a non-judgmental perspective will help to create an atmosphere of trust and support. Depending on the situation, assisting youth in talking with professionals may include helping them to decide whom they might wish to speak with and assisting them or even going with them to their first appointment.

As a parent, what other things can you do?

• Encourage your youth to navigate the youth section of this website
• Educate yourself about non-suicidal self-injury
• Depending on the situation, help your youth to find professional help
• Support attendance at therapist/ doctor appointments

It is important to appreciate that you may need both patience and persistence in order to help your youth. As a parent, your involvement in any course of treatment can be beneficial. Knowledge about self-injury can help you, as a parent, make informed decisions on how best to seek advice and/or treatment and provide support for youth. You may find the following links below helpful.

These books may be useful resources for parents who have self-injuring adolescents:

Welcome to the Youth page.   As you scroll down, you will find some helpful websites and resources about self-injury.

We highly recommend that you talk with a trusted person and consider getting professional help if you are unable to stop self-injuring and/or feel distressed.

Remember, we highly recommend that you talk with a trusted person and consider getting professional help if you are unable to stop self-injuring and/or are feeling distressed.

What is Self-Injury?

Non-suicidal Self-Injury (NSSI) is most often defined as the intentional destruction of body tissue that is not culturally sanctioned and is without conscious suicide intent. The most common forms of NSSI include self-cutting, scratching, burning and hitting. Self-Injury is one of a broader spectrum of self-harm behaviours that may also include ingesting a medication in excess of the prescribed or generally recognized therapeutic dose.

How Common is Self-Injury in Youth?

In a college sample of two Northeastern U.S. universities, a random sample of students completed an Internet based survey (Whitlock, 2006) in which a lifetime prevalence of Self-Injury was reported in 17% of respondents. In Canada, several studies have investigated rates of self-harm in the general population or high school based youth (Ross & Heath, 2002; Laye-Gindu & Schonert-Reichl, 2005; Nixon, Cloutier & Jansson, 2008). Lifetime prevalence rates ranged from 14% to 17%.

In a recent Canadian population based survey of youth ages 14 to 20, three quarters of those who had ever self-harmed were females and most began in mid adolescence. 83.2% reported at least one episode of self injury, while 31.5% ingested medication in a non therapeutically prescribed dose. Almost 40 % of those who had ever self-harmed, did so repeatedly (i.e., more than three times). Over two thirds of youth who self-harmed believed that they got the idea themselves, while much fewer indicated that the idea came from friends, family or the media (Nixon, Cloutier, & Jansson, 2008).

What may Co-occur with Self-Injury in Youth?

There are a number of factors associated with NSSI. These include being female, having symptoms of depression, anxiety, impulsivity, or disruptive disorders, low self-esteem, increased emotional distress, problems with anger control and anger discomfort and drug misuse (Ross & Heath, 2002; Laye-Gindhu & Schonert-Reichi, 2005; Nixon et al., 2008; De Leo & Heller, 2004). Suicidal ideation and attempts are more likely to be reported in those with repeated non suicidal Self-Injury (Whitlock et al., 2007).

Social factors associated with NSSI include awareness of self-harm in peers, having self-harming family members, and families having problems affording basic necessities. Family factors include emotional neglect (Lipschitz, Winegar, Nicolaou, Harnick, Wolfson, & Southwick, 1999), impaired communication (Tulloch, Blizzard, & Pinkus, 1997) and family related stressors (Rubenstein, Halton, Kasten, Rubin, & Stechler,1998). In the latter study, family cohesiveness appeared protective against NSSI.

Why do Youth Self-Injure?

There are many reasons why youth might self-injure. In some cases, there may be more than one reason. Common functions appear to include regulation of affect, such as to reduce tension or relieve dysphoric or unpleasant feelings. Self-Injury may also be used for self punishment, interpersonal reasons, sensation seeking and as an anti-dissociation mechanism (Klonsky, 2007).

As indicated, certain youth who engage in NSSI experience a feeling of relief or tension reduction from self injuring. For this reason some of these youths repeat their self-injuring and see it as “effective” means to temporarily manage difficult feelings. Because of this, Self-Injury had the potential to become an addictive behaviour and may have reinforcing effects at a biological level (Nixon, Cloutier & Aggarwal, 2002). It is therefore helpful to understand that, in certain youths changing this behaviour may take some time and require a number of interventions.

Do youth who Self-Injure seek help?

Forty percent of college students reported that no one was aware that they self injured (Whitlock et al., 2006). For those who did seek help, peers were the most likely to know. Studies of youth who self harm also substantiate that friends were most commonly made aware of this behaviour (De Leo & Heller, 2004; Nixon, Cloutier & Jansson, 2008).

Treating Youth who Self-Injure

More recently, dialectical behaviour therapy (DBT) has been used for youth who self injure. DBT is a skills based therapy that is based on a philosophy of balancing acceptance and change. Specific skills include mindfulness, distress tolerance, emotional regulation and improving interpersonal relationships. Cognitive behaviour therapy may be used to treat specific symptoms associated with depression and anxiety.

While there are no specific medications for the treatment of repetitive self injury, medication may be used to target symptoms of depression, anxiety and/or impulsivity. A critical aspect of therapy is that these youth feel accepted and are not judged for their behaviour. Other aspects of treatment/intervention may include family work, interventions with the school, work around identified stressors and increasing levels of support.

More information about Youth who Self-Injure

This news article includes a review of a Western Canadian survey of youth looking at the prevalence of self harm in youth ages 14 to 21 and associated factors: Survey warns youth hurt themselves to deal with mental stress Tuesday, January 29, 2008 | The Canadian Press at www.cbc.ca

The following article in the Personal Health Section of the New York Times, May 6, 2008, reviews issues related to self injury in youth and young adults: The Growing Wave of Teenage Self-Injury Tuesday May 6, 2008 | The New York Times at www.nytimes.com

The Globe and Mail recently published an article reviewing the role of YouTube videos in teens’ self-injury and risky behaviours: Teens influenced by YouTube videos of self-cutting, risky behaviour: studies Thursday August 12, 2012 | The Globe and Mail at www.theglobeandmail.com

__________ Sources Cited Above:

De Leo D, Heller ST. Who are the kids who self-harm? An Australian self-report school survey. Med J Aust 2004;181:140-4.

Klonsky ED. The functions of deliberate self-injury: A review of the evidence. Clin Psychol Rev 2007;27:226-39.

Laye-Gindhu A, Schonert-Reichl K. Nonsuicidal self-harm among community adolescents: understanding the “whats” and “whys” of self-harm. J Youth Adolesc 2005;34:447-57.

Nixon MK, Cloutier PF, Aggarwal S. Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. J Am Acad Child Adolesc Psychiatry 2002;41:1333-41

Nixon M K, Cloutier P, Jansson M. Nonsuicidal self-harm in youth: a population-based survey. Canadian Medical Association Journal 2008;178(3):306-312.

Lipschitz, D. S., Winegar, R. K., Nicolaou, A. L., Hartnick, E., Wolfson, M., & Southwick, S. M. (1999). Perceived abuse and neglect as risk factors for suicidal behavior in adolescent inpatients. Journal of Nervous and Mental Disease, 187,(1), 32-39.

Ross S, Heath N. A study of the frequency of self-mutilation in a community sample of adolescents. J Youth Adolesc 2002;31:67-77.

Rubenstein J L, Halton A, Kasten L, Rubin C, Stechler G. Suicidal behavior in adolescents: stress and protection in different family contexts. Am J Orthopsychiatry 1998;68(2):274-84.

Tulloch A L, Blizzard L, Pinkus Z. Adolescent-parent communication in self-harm. J Adolesc Health 1997;21(4):267-75.

Whitlock J, Eckenrode J, Silverman D. Self-injurious behaviors in a college population. Pediatrics 2006;117:1939-48.