Young People & Self-Harm

Team Health DXLee Chapman, Nathan M. To, Candice Yee

Primary Contact:Nathan M. To, CCC PhD

Research Consultant | Producernathan.to@ronininstitute.org

THE CHALLENGE

How might we create empowering spaces for young people engaging in self-harm, and

enable them to find help?

(INSPIRATION PHASE)

HERE’S WHAT WE KNOW

1

SELF-HARMIS REAL.

SELF-HARMIS DANGEROUS

SELF-HARMIS COMMON

1 in 5 females +

1 in 7 males

every YEAR

U.S. stats on self-harm injuries: http://www.healthyplace.com/abuse/self-injury/self-injury-self-harm-statistics-and-facts/

engage in SELF-INJURY

That’s...

1 in 4 hospitalizations among youth age 10 to 17

2013-2014 Canadian statistics on intentional self-harm injuries: Canadian Institute for Health Information (CIHI): http://www.cihi.ca/web/resource/en/info_child_harm_en.pdfSee also: http://www.cbc.ca/news/health/self-harm-behind-1-in-4-youth-injury-hospitalizations-1.2839395 http://healthymindscanada.ca/self-harm/

1, 324 hospitalizations (in 2009-2010)

2,500 hospitalizations (in 2013-2014)

Self-harm describes a range of behaviours, including:

➜ Cutting your own flesh➜ Severely scratching your

skin➜ Burning or scalding

yourself➜ Punching things or

throwing your body against walls and hard objects

➜ Hitting yourself or banging your head

➜ sticking objects into skin➜ intentionally preventing

wounds from healing➜ swallowing poison, toxic

substances or inappropriate objects

Our proposal focuses on...

CUTTING

WHAT WE LEARNED(themes)

CUTTING IS

SOCIAL

Cutting behaviour is SOCIAL:

ONLINE + COMMUNITIES

➜ Tumblr➜ Instagram

PEER GROUPS

➜ Peer Pressure➜ Cut to “fit in”

Past research suggested self-harm occurs in physical isolation.

THIS HAS CHANGED.

CUTTING HAS

BIOCHEMICALASPECTS

CUTTING IS A

COPINGSTRATEGY

KEY INSIGHTS

Young people see their cuts as battle scars,

a source of pride among those who cut.

(INSIGHT THEME 1)

Young people cut

to make connections with others.

There is a tight-knit group online of young people who self-harm.

Some are recovering, many are still active.

Cutting can involve

Peer Pressure

e.g. in an effort to fit in with a social group, young people may experiment with cutting when they see their friends doing it

Cutting can be addictive.

Young people who cut cannot help themselves.

Cutting triggers a biochemical reaction in the brain.

(INSIGHT THEME 2)

Serotonin, Dopamine & Endorphins interact…

Cutting feels Soothing.

Factoids:These are brain neurotransmitters. Sometimes called the “happy chemicals”.

Serotonin: mood related. associated with feelings of pride & significance. Low amounts mean higher impulsivity

Dopamine: associated with the good feeling of achieving rewards. Addictive.

Endorphins: brings euphoric feelings that mask pain. e.g. runner’s high

Sources: http://goo.gl/dqfApq http://goo.gl/vJ5aRV http://goo.gl/mNp0fJ

even Rewarding.

so People who cut get some hormone-rush and feel soothed from cutting.

The “soothing” experienced by those who cut differs with each individual.

Cutting can be experienced differently:

as numbing or

feeling more alive.

Thus, cutting can feel rewarding,reinforcing & addictive

for those in emotional pain.

Young people cut

to cope with overwhelming emotions.

(INSIGHT THEME 3)

A goal of cutting is to deal with emotional pain.

e.g. Sadness, depression, anger, trauma, bad memories

Thus,

Cutting is a way to

help with emotional regulation

“We can’t just take away

someone’s coping strategy without replacing it with

something else”

They need support to find alternate ways of coping / emotional regulation

Can’t just tell those who cut to stop.

“Telling young people to go ‘COLD TURKEY’ will not work.”

Emotional pain is made worse when young people

shame & blame themselves for cutting

More support & public understanding is needed.

Stigmatizing those who

cut reinforces the shaming cycle.

(IDEATION PHASE)

HOW MIGHT WE...

2

How might we reward young people differently--

so that they feel the same amount of pride without

harming themselves?

How might we help break the cycle of

biochemical reward & reinforcement

in people who cut?

How might we direct people to alternate ways of coping

when they are overwhelmed and feel compelled to cut?

we came up with a lot of exciting, innovative ideas…

here’s one of them...

a GRAPHIC NOVEL

It will create an engaging, visual and emotionally stimulating way

of reaching young persons engaging in self-harm.

They are “cool”, accessible & also relatively less expensive to produce (e.g. compared to our more tech-focused solutions)

Distribution can involve

local libraries, schools, community centres, & both independent & mainstream book outlets

Graphic novels can be accessed

regardless of whether young people self-harm or not.

This wide appeal prevents young people from seeing themselves as a “problem”.

“The person is not the problem. The problem is the problem.”

-Michael White, Narrative Psychotherapist

Thus, this wide appeal helps reduce the

stigma of persons engaging self-harm,

preventing cycles of self-shame.

PHASE

PROTOTYPE

3

A graphic novel:

...adapted from Real Stories

...based on actual experiences of real people who have struggled with self-harm in the past or present.

Developed in collaboration with:

...writers who have close knowledge of self-harm issues.

...clinical professionals, social science researchers, educators & other key experts on self-harm.

F . M. L .

FML is real and raw

FML is the sentiment driving despair

and hopelessness, and the

compulsion to self-harm

fml can and will be turned on its

head, showing our audience that

there is redemption and hope

fm

FML the graphic novel

a seven part series

each part, a stand-alone piece, is anchored

on a unique character

each part explores the lives and struggles

of each character

all the characters share one thing in

common - a history of self harm and a way

out of their own personal hell

fm

The world

contemporary suburban

wasteland where teen girls

deal with a lethal

combination of ennui and

abuse

● Amy’s story opens with

blood and gore, and a

paramedic rescue - then the

story takes us back to how

she got here. and the

redemption that saves her.

● amy comes from a middle

class suburban household

● her dad is irish, her mom is

chinese jamaican

● she is bullied constantly by

other kids who don’t get her

mix.

● she becomes socially

anxious and depressed. she

becomes reclusive,

retreating in a world of

online games and anime

● she starts to hurt herself,

first with a pin prick. but it

doesn’t stop there.

Amy, 15 - Mixed and weird

C

H

A

R

A

C

T

E

R

1

Graphic Novel Cover

Information included for people who need help

Brief Cover Page

If you are, or know anyone who currently engages in self-harm, please urge them to call:

1-800-Alt-Cut

EVALUATION

4

People said...

"It's cool. I don't cut, but this will help me understand why other people in my school do it. And maybe I can pass this along to them." - teenage girl

“Many people enjoy reading graphic novels and they can speak to people in different ways. This mode also caters to those of varying degrees of reading abilities so can target a wider audience. In this way the message can be delivered which is better than a flyer or only textual format that might overwhelm people...it will also help those who are creating the graphic novel to cope and reflect on what happened in their lives and bring meaning to their experience; thereby, serving multiple people.”

-Dr. D.M. Law, Assistant Professor, WLUYouth & Children’s Studies & Psychology

In future iterations...

We will tell different

stories

about characters that...

...may not fit a stereotypical teen subculture.

We will tell their unique, personal story.

We will also tell

inclusive stories...

....stories that embrace cultural diversity & sexual diversity.

Unique backgrounds.

Unique contexts.

Shared struggles.

Shared emotions.

and

Different definitions

of three, powerful letters.

F . M. L .

what Does it

really

stand for?

Thanks!Team Health DXMembers: Lee Chapman, Nathan M. To, Candice Yee

For more details or collaborations, please contact us. Look forward to hearing from you.

Primary Contact:Nathan To, CCC PhD

Research Consultant/Counsellornathan.to@ronininstitute.org

ACKNOWLEDGMENTS

This presentation was originally created for the IDEO/Acumen “Human-Centred Design” course on NovoEd.

➜ Presentation template by SlidesCarnival➜ Photographs by Death to the Stock Photo

(license)

CREDITS

Special thanks to all the people who made and released these awesome resources for free:

➜ Presentation template by SlidesCarnival➜ Photographs by Death to the Stock Photo

(license)