Thu 20 Jan 2011 In: Health and HIV View at Wayback View at NDHA
Are LGBT youth at risk of self-harm? Firstly, what is self-harm? According to the American Psychological Association's Diagnostic and Statistical Manual IV, self-harm is the deliberate infliction of self-injury on bodily tissue without suicidal intent. It is usually associated with injury to skin through cutting in the United States and United Kingdom, although in New Zealand, a Royal Australian New Zealand College of Psychiatrists information booklet referred to self-poisoning as the predominant means of self-harm within the New Zealand context. It may encompass cutting, burning, pulling out ones hair, self-bruising, scratching oneself or self-poisoning. It may be an indirect consequence of substance abuse or eating disorders, but tissue damage occurs as a result of these problems, not as a primary sign. That said, there is a complex relationship between self-harm, increased risk of suicide and completed suicides. It is also correlated with depression, anxiety attacks, substance abuse, eating disorders and low self-esteem. If it is a consequence of low self-esteem, then antidepressants or therapeutic intervention may be useful. Often, self-harming individuals are aware that they have such a problem, but may wear baggy or long-sleeved clothing to conceal their self-injuries if these arise from cutting. As noted above, it may be a consequence of other forms of mental illness or substance abuse, although poverty, unemployment, dysfunctional family circumstances, benzodiazepine withdrawal or abuse and social context are also involved. This might suggest that homophobic family, educational or peer relationships could contribute to the creation of self-harming behaviour amongst LGBT youth. Whether there are significant divergences between means of LGBT youth self-harm and those of straight counterparts remains uncertain. According to the RANZCP, self-harm is most prevalent between those fifteen to nineteen years of age, and accounted for ten percent of all youth hospitalisations in 2005, usually involving self-poisoning and usually amongst young women, who are likelier to overdose on prescription drugs than men are. According to Dr Julia Garisch (Victoria University of Wellington), social context and relationships increase young men's likelihood of self-harm, while emotional difficulties or low self-esteem affect those of young women. Unfortunately, New Zealand has no more current resources other than the aforementioned RANZCP booklet (2005), although the United Kingdom has a National Self-Harm Network and other resources that could be useful. In addition, the forthcoming APA Diagnostic Statistical Manual V may have a section that deals with Non-Suicidal Self-Injury as a distinct diagnostic category, which may affect funding for research and treatment options as a consequence. If one is concerned that one might self-harm, they should contact their GP, who may then refer them to a youth community mental health worker or amenable therapist. WINZ can assist with Independent Youth Benefits or limited paid counselling provision funds if they are required. If they have self-harmed, then they may need to visit an accident and emergency department at a local hospital. Recommended: Wikipedia: Self-Harm: http://en.wikipedia.org/wiki/self_harm [Note: Heavily oriented toward non-New Zealand sources] Royal Australian and New Zealand College of Psychiatrists: Self Harm: Clinical Practice Guidelines (2005): http://www.ranzcp.org/images/stories/ranzcp-attachments/Resources/Publications/CPG/NZ_Versions/NZ_Self_harm.pdf National Self-Harm Network UK: http://www.nshn.co.uk Young People and Self Harm UK: http://www.selfharm.org.uk Living With Self-Harm: http://www.thesite.org/community/reallife/truestories/livingwithselfharm [One young lesbian's experiences]. Royal College of Psychiatry: http://www.rcpsych.ac.uk/mentalhealth.info/problems/depression/self-harm.aspx Craig Young - 20th January 2011