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Self harm.  What is it? what are some factors people self harm? and how to help?

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Self harm.  What is it? what are some factors people self harm? and how to help?

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Online Prevention source via Lifeline Australia. Discussing what self harm is and reasonings why this may occur and how to help someone who self harms.

This source is a credible source retrieved from Self-Harm. (n.d.). Retrieved from https://www.lifeline.org.au/get-help/topics/self-harm

https://www.lifeline.org.au/get-help/topics/self-harm

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Harmful or helpful? The role of the internet in self-harming and suicidal behaviour in young people

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Harmful or helpful? The role of the internet in self-harming and suicidal behaviour in young people

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Discusses how the internet provides both pro-suicide and suicide prevention websites (credible).

Bell, J (2013)Harmful or helpful? The role of the internet in self-harming and suicidal behaviour in young people. Retrieved from https://www-emeraldinsight-com.ezproxy.ecu.edu.au/doi/full/10.1108/MHRJ-05-2013-0019

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Phillips, D. P. (1974). The Influence of Suggestion on Suicide: Substantive and Theoretical Implications of the Werther Effect. American Sociological Review,39(3), 340. doi:10.2307/2094294

Have a read of this, it may be quite old but was good. This source is a credible source.

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Suicide Prevalence in disadvantaged communities.

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Suicide Prevalence in disadvantaged communities.

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Non-credible newspaper article suggesting lower socioeconomic status and poor education increases risk of suicide in the UK.

Davies, C. (2017). Strong link between disadvantage and suicide, says samaritans. The Guardian. Retreieved from https://www.theguardian.com/society/2017/mar/06/strong-link-between-disadvantage-and-suicide-says-samaritans

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The state of the British economy, including low incomes, job insecurity, zero-hours contracts, unmanageable debts and poor housing, is putting people at increased risk of suicide, according to a report by the Samaritans.

The report, Dying from Inequality, says there is "overwhelming evidence of a strong link between socioeconomic disadvantage and suicidal behaviour".

It says governments should place a stronger emphasis on suicide prevention as an inequality issue. It calls for national suicide prevention strategies to be targeted at the most vulnerable people and places, in order to reduce geographical inequalities in suicide.

Samaritans also calls on workplaces to put in place suicide preventions plans and provide better psychological support for employees experiencing job insecurity or affected by downsizing.

"Men in the lowest social class, living in the most deprived areas, are up to 10 times more at risk of suicide then those in the highest social class living in the most affluent areas," the report says.

Recent research indicates middle-aged men are at higher suicide risk due to economic recession. Unemployed people are two to three times more likely to die by suicide than those with a job.

The least skilled occupations have higher rates of suicide, and a low level of educational attainment and no home ownership has been found to increase an individuals risk of suicide, the report says.

Suicide rates are two to three times higher in the most deprived neighbourhoods compared to the most affluent, and admissions to hospital after self-harm are two times higher.

Disadvantaged people are less likely to seek help for mental health problems and less likely to be referred by GPs to specialist mental health services after self-harm, the report says.

The Samaritans chief executive, Ruth Sutherland, said: "Living in poverty shouldn't mean losing your life. Going through difficult times like losing your job or being in debt shouldn't mean not wanting to live. But that is what's happening in the UK and Ireland today. Suicide is killing the most disadvantaged and vulnerable people, devastating families and communities."

Among the recommendations is better training of service staff in disadvantaged areas. "Government, public services, employers, service providers, communities, family and friends all have a role in making sure help is relevant and accessible when it matters most," Sutherland said.

"Everyone can feel overwhelmed at times in their life. People at risk of suicide may have employers, or they may seek help at jobcentres or go to their GP. They may come into contact with national and local government agencies, perhaps on a daily basis. So, in the light of this report, we are asking key people and organisations from across society - for example, those working in housing, in businesses, medical staff, job centre managers - to all take action to make sure their service, their organisation, their community is doing all it can to promote mental health and prevent the tragedy of suicide."

A government spokesman said: "Every death by suicide is a tragedy but we are taking action to make sure we reduce rates by 10 per cent by 2020. In January, we launched our updated suicide prevention plan - this sets out how local areas should do more to support those who are at higher risk of suicide. We know that financial insecurity can be a big factor and want to see more targeted, joined-up ways of reaching out to those in the most vulnerable circumstances."

* In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here. Topics

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Strong link between disadvantage and suicide, says Samaritans

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The state of the British economy, including low incomes, job insecurity, zero-hours contracts, unmanageable debts and poor housing, is putting people at increased risk of suicide, according to a report by the Samaritans. The report, Dying from Inequality, says there is "overwhelming evidence of a strong link between socioeconomic disadvantage and suicidal behaviour".

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Statistics that are usefull for referencing to in essay. Standardised death rates, 2015.

Credible source: ABS, (2015). Causes of Death, Australia; Suicide in Australia. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2015~Main%20Features~Intentional%20self-harm:%20key%20characteristics~8

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3303.0 - Causes of Death, Australia, 2015

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Footnote(s): (a) Standardised death rates. Deaths per 100,000 of estimated mid-year population. See Glossary for further information. (b) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 85-93.

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Talking about self harm and suicide in schools can save lives

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Talking about self harm and suicide in schools can save lives

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An online article promoting talking about the issues of self harm and raising awareness. Credible source that gives us an idea of the social side of moral panic around self harm.

Stanford, S. (2017). Talking about suicide and self-harm in schools can save lives. The conversation. Retrieved from https://theconversation.com/talking-about-suicide-and-self-harm-in-schools-can-save-lives-83232

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Suicide and self-harm remain taboo topics in schools, despite the fact youth suicide has reached a ten year high.

Recent statistics show around eight children and young people die by suicide each week in Australia. Around one in ten self-harm during their teenage years. This loss of life means that the topic is too important not to talk about, but parents and teachers are often concerned that talking about suicide or self-harm may put ideas in young, impressionable minds.
Further reading: Australian teens doing well, but some still at high risk of suicide and self-harm.
Teachers and parents are often concerned about putting ideas in students' heads. They worry talking about it more will lead students to swap strategies and compare wounds, and whether there are resources to support additional disclosures.

The World Suicide Prevention Day (September 10) and RUOK Day (September 14) campaigns are encouraging people to have honest conversations about suicide and mental health. To do so, we need to dispel the myths that encourage silence on these topics.

World Suicide Prevention Day

Why do we need to talk about self-harm and suicide?

A prevailing myth about self-harm is that people do it for attention. If we follow this logic, we can assume that we will naturally identify those who are engaging in self-harm or considering suicide. Overwhelmingly, research does not support this idea. Only around half of young people who self-harm disclose the behaviour to anyone. Young people often go to great lengths to hide self-harm.

It can be very hard to admit self-harm or suicidal thoughts. People may fear a negative response or worry that information will be spread without their consent. Some young people may not view their behaviour as a problem. Self-harm is often a way of trying to cope with overwhelming emotions, and some people may feel that this strategy is "working".

Teachers and parents might be on the look-out for warning signs for self-harm or suicide, such as depression, anxiety, low self-esteem, or experiencing stressful life events. However, our recent research highlights that not all young people who self-harm fit this profile. Yes, we need to keep an eye out for self-harm, suicidal behaviour, and other mental health difficulties, but unfortunately this is not enough.

As a community, we need proactive, positive strategies to reduce youth self-harm and suicide. Schools are on the front line of this work because they provide the greatest access to young people.

Will discussing self-harm and suicide encourage it?

This is a common concern from school staff and parents. There is emerging evidence suggesting that selected self-harm and suicide programs:

do not increase self-harm thoughts or behaviours;

reduce suicide attempts and severe suicidal ideation;

improve knowledge and attitudes; and

increase help-seeking behaviour.

Ongoing research is needed to strengthen the evidence for prevention programs, taking into account youth perspectives and measuring suicide and self-harm related outcomes. At this point in time, research findings indicate that schools can talk about self-harm and suicide positively and safely when approached in the right way.

How do we have these conversations safely?

First and foremost, we need to build supportive communities so that young people are willing to disclose self-harm and suicidal thoughts. A teenager spends 30+ hours a week at school, but being around people does not automatically provide genuine connection, where each young person feels safe and supported. This isn't an easy task to accomplish, but it can't be neglected among the hustle of programs and policies.

So we need to implement evidence-based self-harm and suicide prevention programs. Research and practice indicates that programs should be framed within broader mental health programs that focus on protective behaviours and strengthening resilience. Programs should be available to all students, not just those who appear to be at risk. Programs should educate and empower, and should not include graphic images or graphic descriptions of behaviour.

It is likely that discussing self-harm and suicide will result in identifying new cases that were previously unknown to the school. While this is a positive outcome, this can place a greater burden on already stretched welfare teams. Schools can prepare for this by ensuring staff know the protocols following disclosure, and establishing good relationships with external services.

It's not just staff that need to know how to respond. Teens are most likely to disclose to a friend rather than an adult. When disclosing to an adult, it's more likely to be a parent rather than a counsellor or teacher. This means all members of the community need to know how to respond in safe and supportive ways.

People should be aware of support available outside school too. Online services may be less intimidating for those reluctant to seek help.

Talking about self-harm and suicide isn't easy, but it's a conversation that can save lives.

For support:

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Talking about suicide and self-harm in schools can save lives

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Suicide and self-harm remain taboo topics in schools, despite the fact youth suicide has reached a ten year high. Recent statistics show around eight children and young people die by suicide each week in Australia. Around one in ten self-harm during their teenage years.

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Headspace is a non for profit organisation aimed at youths 15-25 years old. Statistics on here are reliable.

A page aimed at youths and their caretakers to help educate the reasons behind self-harm. Describes how it is an issue from current youth in Australia.

Credible source: Headspace: Understanding self-harm - Young people. Retrieved from https://www.headspace.org.au/young-people/understanding-self-harm-for-young-people/

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Understanding self-harm - Young people - headspace

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Understand what is self harm, why people self harm and what you can do to help someone you know, or manage self harm. Start with our factsheet and resources

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Talking about Suicide
This source bust the myth  that discussing suicide and self harm will just give youth ideas. However discussing it and providing the support will help prevent it.

This source is a credible source: beyondblue - Healthy Families. (n.d.). Retrieved from https://healthyfamilies.beyondblue.org.au/age-13/mental-health-conditions-in-young-people/suicide

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It can be frightening and distressing when someone you care about is considering taking their own life. Suicide prevention starts with recognising the warning signs and taking them seriously, talking to your young person about what's going on, and helping them seek professional support.

Feelings of despair and hopelessness are not uncommon in a young person with anxiety and depression. But while many young people have thoughts of suicide, only some of them begin to think about it as a real option - the only alternative to the overwhelming distress or unbearable pain they're feeling.

It's important to realise that most suicidal young people don't want to die. Rather, they've run out of ways to cope with their pain and all they can see ahead of them is despair. With support, they can find better ways to manage their distress and get through the crisis.

Talking about suicide

Don't be afraid to ask direct questions about suicide. You can't 'put the idea of suicide' in someone's head by talking about it.

In fact, by asking questions, you may prevent suicide by showing your young person that you care and are there to help. Asking direct questions can also help you to determine if they're in immediate danger and in need of assistance.

Here are some ways to ask a young person if they are considering suicide:

"Are you feeling so bad that you're thinking about ending your life?"

"Are you having thoughts about suicide?"

"Do you ever wish you were dead?"

You should never promise to keep thoughts or feelings about suicide a secret. Keeping the secret may be extremely harmful, if not fatal. Be sure to tell the young person that you are unable to keep their secret. Even if they seem upset with you now, they will thank you later.

Youth suicide - the issues

Youth suicide affects families every day in Australia. It is the leading cause of death among young people, with around 350 young people aged 15-24 dying by suicide in 2013.[i]

Although these are startling numbers, what is even more concerning is what we don't know. Research shows that in this age group, for every one suicide there are approximately 100-200 suicide attempts.[ii]

While suicide can affect anyone regardless of age, gender, race, income and family background, some young people are at greater risk of self-harm and suicidal behaviour.

Although these numbers are alarming, the good news is that youth suicide is mostly preventable.

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It can be frightening and distressing when someone you care about is considering taking their own life. Suicide prevention starts with recognising the warning signs and taking them seriously, talking to your young person about what's going on, and helping them seek professional support.

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Headspace is a non for profit organisation aimed at youths 15-25 years old. Statistics on here are reliable.

A page aimed at youths and their caretakers to help educate the reasons behind self-harm. Describes how it is an issue from current youth in Australia.

Credible source: Headspace: Understanding self-harm - Young people. Retrieved from https://www.headspace.org.au/young-people/understanding-self-harm-for-young-people/

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Understanding self-harm - Young people - headspace

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Understand what is self harm, why people self harm and what you can do to help someone you know, or manage self harm. Start with our factsheet and resources

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Exploring the myth that talking about suicide will put the idea in young peoples heads

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Exploring the myth that talking about suicide will put the idea in young peoples heads

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This source discusses suicide ideation, and busts the myths and stigmas surrounding it this source is a credible source retrieved from
(2018). Headspace.org.au. Retrieved 14 April 2018, from https://headspace.org.au/assets/Uploads/Resource-library/Health-professionals/suicidal-ideation-mythbusterv2.pdf

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Talking to teens about suicide appears to ease distress

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Talking to teens about suicide appears to ease distress

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School based suicide prevention programs

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School based suicide prevention programs

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A randomised trial assessing the effectiveness of different education programs about suicide and self harm. Includes a 'Youth Aware Mental Health Program' aimed at students and a 'Question, Persuade an d refer' program aimed at educating the staff and teachers.

Wasserman, D (2015). School based suicide prevention programs: the SEYLE cluster-randomised, controlled trial. The Lancet. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61213-7/fulltext

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Myth busters around self-harm - aimed at youths to stop stigma attached to mental illness and self harm.

A credible source: Headspace: Myth buster; Sorting fact from fiction. Retrieved from: https://headspace.org.au/assets/Uploads/Resource-library/Health-professionals/self-harm-mythbuster.pdf

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RUOK an organisation that encourages people to talk about suicide and self harm as a prevention (not academic)

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RUOK is a suicide prevention charity in Australia, reminding people that having meaningful conversations with mates and loved ones could save lives.

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suicide facts and helplines and guides to know the signs 

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suicide facts and helplines and guides to know the signs 

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A credible source in regards to finding the signs and guidelines in order to discuss and learn the signs

Retrieved from FAQs About Suicide | Crisis Centre. (2018). Crisiscentre.bc.ca. Retrieved 5 April 2018, from https://crisiscentre.bc.ca/frequently-asked-questions-about-suicide/

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If someone is seriously contemplating suicide, do you really think it is possible for them to make a decision to live?

We know that those at risk for suicide do not necessarily want to die, but do want help in reducing the pain they are experiencing so that they can go on to lead productive, fulfilling lives. There is a lot of ambivalence surrounding the decision to take one's own life, and by recognizing this, and discussing it, we can help the suicidal person start to recognize alternative options for managing their suffering. Often suicidal people are experiencing intolerable emotional pain, which they believe to be unrelenting. They often feel hopeless and trapped. By helping them to recognize and explore alternatives to dying, you are planting the seeds of hope that things can improve.

Will talking about suicide to a person make them suicidal?

There is no research evidence that indicates talking to people about suicide, in the context of care, respect, and prevention, increases their risk of suicidal ideation or suicidal behaviours. Research does indicate that talking openly and responsibly about suicide lets a potentially suicidal person know they do not have to be alone, that there are people who want to listen and who want to help. Most people are relieved to finally be able to talk honestly about their feelings, and this alone can reduce the risk of an attempt.

Is talking about suicide, or threatening to kill yourself just a ploy to get attention?

It is best to treat talk and threats about suicide seriously. Research indicates that up to 80% of suicidal people signal their intentions to others, in the hope that the signal will be recognized as a cry for help. These signals often include making a joke or threat about suicide, or making a reference to being dead. If we do take them seriously and ask them if they mean what they are saying, the worst that can happen is we will learn that they really were joking. Not asking could result in a far worse outcome.

If someone makes a suicide attempt, but does not die, is this just looking for attention?

At some level, all suicide attempts are cries for help by individuals experiencing a high degree of desperation. It is important to treat all attempts as serious. Once an attempt is made at any level of lethality, the risk for future and more serious attempts and completion increases significantly.

If a person who was depressed and suicidal suddenly seems to feel better, does this mean they are no longer at risk for suicide?

Hopefully, if a person seems better, they are indeed feeling better and are no longer considering suicide. HOWEVER, this apparent upswing in mood could also be an indicator of an increased risk of suicide. Sometimes, a suicidal person might feel relief that they have finally come to a decision - the emotional conflict over living or dying has been resolved. The best way to determine if a person's improved mood is related to decreased or increased risk of suicide is to have a direct and open discussion about suicide.

If a person is suicidal, does this mean they will always be suicidal?

Most suicidal people are desperately seeking a way out of unbearable emotional pain and are ambivalent about ending their own lives. After receiving help to overcome this pain, many people go on to live rewarding and meaningful lives, never again seriously contemplating suicide. For others, a current suicidal crisis may be overcome and the risk of suicide significantly lowered or eradicated for a period of time. This period of time can range from minutes, hours or days, to possibly months, or even several years.

What are the warning signs that someone might be considering suicide?

About 80 per cent of people who attempt or complete suicide send out warning signs to those around them, although they may not make a direct plea for help. Some warning signs may include:

Talking or joking about suicide or dying;

Making preparations for death such as giving away significant possessions, making a will, writing a suicide note, clearing up loose ends;

A previous suicide attempt; the suicide of someone important;

Being persistently depressed or down for more than a couple of weeks; protracted anxiety or agitation; extreme mood swings/bipolarity; outbursts of rage, grief, violence;

Isolation, withdrawal from previously enjoyed relationships and activities;

Lethargy, lack of interest, low energy, insomnia or over-sleeping;

Increased use of alcohol or drugs;

Uncharacteristic high risk activity, impulsive behaviours

Expressions of hopelessness, helplessness, purposelessness

Low self-esteem, low self-worth, self-contempt, anger toward self;

Significant loss(es), such as important relationship, health, identity, economic security, freedom.

What can we do if we think someone is suicidal?

It is important to show a potentially suicidal person that we care and that we are concerned for their safety. It is also important to directly ask the person if they are considering suicide. This shows that we are taking their feelings seriously, and helps to establish if the risk for suicide is real. If you feel uncomfortable asking, it is important that you get someone else to ask. We need to listen to the person - without judgment and by showing empathy. If the person says they are considering suicide, we need to get help for that person by enlisting the help of professionals, such as a family doctor, a mental health professional, a 24-hour crisis line, or even a hospital emergency room if the person is imminently at risk. It is also important to enlist familial, friendship and social supports. If the person is at imminent risk of harming themselves, do not leave them alone until they have been assessed and received help from a competent and trustworthy professional, or until another trustworthy adult arrives to stay with them.

Don't suicides happen fast, and usually as the result of one sudden traumatic event, so that it is hard to prevent them?

Suicides can appear to happen fast, or "out of nowhere," when we have not noticed any indications of a person's suicidality. Although most people (80%) present a range of indicators to the people around them, few of us have been educated to recognize these warning signs and we miss them.

Suicides are also rarely the result of a single traumatic loss or change. Usually, there are many contributing factors and events that have developed or occurred over a period of time. A sudden traumatic event may be the 'trigger' event that moves a person to end their life, but it is unlikely the only cause.

It is likely that many suicides could be prevented if we educated ourselves about the immediate, short term, and long term indicators of suicidal risk, as well as how to reach out and get effective help for someone who is letting us know they are in serious distress.

What is the link between mental health and suicide?

Research suggests that 70 to 90 per cent of people who have made a lethal attempt, or died by suicide, were suffering from one or more unmanaged mental health issues - such as protracted depression or anxiety, bi-polarity, psychosis, and/or substance abuse. While the presence of an unmanaged mental health issue is strongly associated with suicide, it is important to note that most people assessed with a mental illness are not at risk of suicide, and that few suicides are wholly the result of a mental illness.

Do 'copycat suicides' really occur?

Yes, there is evidence to show that 'copycat suicides' do occur under some circumstances. If someone is already vulnerable (depressed, anxious, isolated, has made a previous attempt, and/or is showing other warning signs), one suicide can trigger another. "Copycat suicides" or "suicide contagion" is most pronounced when someone loses someone close to them. Youth also appear to be especially vulnerable. Other conditions that can increase the risk of 'copycat suicides' are high profile, sensational portrayals of suicide in the media, or inadvertent glorification of a suicide victim.

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We know that those at risk for suicide do not necessarily want to die, but do want help in reducing the pain they are experiencing so that they can go on to lead productive, fulfilling lives.

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Facts and statistics about suicide ideation and the links when discussing them

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Facts and statistics about suicide ideation and the links when discussing them

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The source discusses the plausibility that discussing suicide and self harm brings ideas to young people and the links associated

This source is a credible source retrieved from (2018). Kcl.ac.uk. Retrieved 15 April 2018, from https://www.kcl.ac.uk/kcmhr/publications/assetfiles/2014/Dazzi2014a.pdf

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Does discussing suicide makes people more suicidal and bring on more self harm

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Does discussing suicide makes people more suicidal and bring on more self harm

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This source discusses the plausibility that discussing suicide and self harm will bring on ideas and thoughts of suicide

This source is a credible source: Hammond, C. (n.d.). Does discussing suicide make people feel more suicidal? Retrieved from http://www.bbc.com/future/story/20140112-is-it-bad-to-talk-about-suicide

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Asking someone whether they're considering taking their own life when they seem desperate is never going to be easy. It's not just the highly awkward or sensitive nature of the conversation. Some fear that merely raising the subject of suicide could be dangerous, in case it puts ideas in a person's head.

Some studies have supported this belief, to a degree. In one study conducted in London health clinics, a quarter of family doctors and a fifth of patients believed that asking people about suicidal thoughts could induce ideas of self-harm. This may be a minority only, but this belief is worth examining in more detail because it means that many people avoid the subject - which could prevent desperate people from discussing their feelings, not to mention pursuing other options or getting help.

Suicide-prevention policies in Europe and North America often focus on primary care because it's these family doctors who frequently see people with depression (not that everyone who attempts suicide is depressed). These clinics may be a key location for finding people who feel they can't cope, but in practice few doctors ask about suicide - one reason being fear of inducing suicidal thoughts.

In a study called "Let's not talk about it", conducted in Northern California, actresses were trained to play the roles of patients with symptoms of major depression visiting a doctor. Recordings of the consultations revealed that fewer than 27% of the doctors enquired whether the patient had considered killing themselves. The study's authors suggest that some seemed uncomfortable about discussing it, feared that it would encourage suicide attempts, or that if the patient did have suicidal feelings they would not have sufficient expertise to intervene. But, interestingly, those who had experience of depression in their personal lives, whether themselves or friends or family, were more likely to broach the subject. It also made a difference if patients asked for anti-depressants: doctors were more likely to start a conversation about suicide, although not so much if they requested them by brand.
Distress test
In an attempt to work out once and for all whether discussing suicidal feelings could make people feel more suicidal, clinical epidemiologist Madelyn Gould conducted her own randomised controlled trial in 2005. More than two thousand students at six high schools were given questionnaires to measure their mood and levels of distress. Half of them were also asked questions about suicidal feelings, which they could answer on a scale ranging from "I never had this thought" to "This thought was in my mind almost every day". Two days later, both groups were again given questionnaires to assess their levels of depression and distress, but this time both groups were asked about suicidal thoughts. If discussing suicide is harmful then the group asked about suicidal thoughts first time around would show higher levels of distress two days later. But, in fact, they showed slightly less distress than the other group, possibly because they felt their feelings had been taken seriously.

This was followed up with a trial in 2011, where patients attending a doctors' surgery in London were given a questionnaire asking them just two questions: "During the past month have you often been bothered by feeling down, depressed or hopeless?"; and "During the past month have you often been bothered by little interest or pleasure in doing things?" Those who said yes to one or both questions were then phoned by a researcher who asked a series of questions about their mood. Half were randomly assigned to a group where they were also asked six questions on the topic of suicidal thoughts. The other half weren't asked these questions. Two weeks later, a follow-up interview assessed their mental health. Two hundred people isn't a large enough study to measure actual suicide attempts amongst the two groups, but it was enough to demonstrate that discussion of suicide hadn't increased suicidal feelings two weeks later.

This doesn't mean that all mention of suicide can be helpful. Talking about it is one thing; showing people how to do it is another. After a British hospital drama featured a man taking an overdose, and included details of the exact drug and amount that he took, data collected from 49 accident and emergency departments the following week showed a 17% increase in overdoses. In the four weeks following the suicide of a celebrity in Taiwan, where the method used had received a great deal of media coverage, once again suicide attempts rose. Within psychology this is referred to as modelling, where people copy a behaviour they see someone else doing. Many media organisations now follow guidelines to avoid detailing methods.

Portraying methods is very different from discussing feelings about not wanting to live anymore. Opening up a conversation can help people to see alternative ways out of their situation, and around the world there are many different organisations that provide people with someone to talk to, whether on the phone, online or in person. So if someone says they are considering suicide, it's a myth to think that talking to them about their feelings will further endanger their lives.
To find someone to talk in your country go to www.befrienders.org/directory. If you would like to comment on this, or anything else you have seen on Future, head over to our or page, or message us on .
Disclaimer All content within this column is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you're in any way concerned about your health.

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Does discussing suicide make people feel more suicidal?

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Asking someone whether they're considering taking their own life when they seem desperate is never going to be easy. It's not just the highly awkward or sensitive nature of the conversation. Some fear that merely raising the subject of suicide could be dangerous, in case it puts ideas in a person's head.

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Suicide and the Internet: Changes in the accessibility of suicide-related information between 2007 and 2014

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Suicide and the Internet: Changes in the accessibility of suicide-related information between 2007 and 2014

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Biddle, L., Derges, J., Mars, B., Heron, J., Donovan, L., Potokar, J., Poper, M., Wyllie, C. & Gunnel, D. (2016). Suicide and the Internet: Changes in the accessibility of suicide-related information between 2007 and 2014. Journal of affective disorders. Vol 190, pp. 370-375.

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How to talk to your teen about depression, suicide 

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How to talk to your teen about depression, suicide 

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Understanding and responding to children and young people at risk of self-harm and suicide

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Understanding and responding to children and young people at risk of self-harm and suicide

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Just some background info on self harm from SANE Australia site

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Self-harm means any behaviour which involves the deliberate causing of pain or injury to oneself - usually as an extreme way of trying to cope with distressing or painful feelings.

Self-harm includes cutting, burning or hitting oneself, binge-eating or starvation, or repeatedly putting oneself in dangerous situations. It can also involve abuse of drugs or alcohol, including overdosing on prescription medications.

Why do people harm themselves?

Self-harm is often a response to feelings of extreme psychological distress or emotional pain. It may provide short-term relief from these feelings. It may be an attempt to express or even control them briefly. It does not resolve them, however, and can become a compulsive and dangerous activity.

While people who self-harm may not intend to end their lives, the consequences of this risky behaviour can be fatal, and it needs careful assessment and care by a health professional.

How do you get help if you self-harm?

As well as being physically dangerous, self-harm is often a sign that the person needs help for a mental health problem associated with the behaviour. This might be an anxiety disorder, depression or some other condition. It is therefore very important to see a GP or other health professional for an assessment and diagnosis, and to discuss a treatment plan. Treating the underlying causes will help make a long-term difference to reducing and stopping the impulse to self-harm.

Treatment is likely to involve seeing a psychologist who is an expert in this area, and will know how to best help the person, as well as help them to help themselves.

It's a good idea to prepare for seeing a doctor by talking to a trusted person about the self-harming behaviour. This might be a family member or friend, or a suitable person at school or work. It's also helpful to request a longer appointment, so there is time to talk, and take along some simple notes - for example, detailing how long the self-harming has been going on, and any other feelings or events which may be associated with it.

Because self-harming behaviour is risky and possibly life-threatening, do not hesitate to call emergency services on 000 if necessary.
Related: How to help in a crisis
Are there alternatives to self-harm?

It can be hard for people who self-harm to stop it by themselves. That's why it's important to talk to someone and see a doctor. It can help to try alternatives to self-harm which can relieve distress in the short term. These include:

Delay: for example, put it off until you have spoken to someone

Distract: for example, go for walk, play a game

Divert: for example, find an activity which has a similar effect to self-harm, but without causing injury, such as punching a pillow, drawing on arm instead of cutting, squeezing an icecube

Deep breathing: or other relaxation method

These are not solutions to self-harm but can be useful as short-term alternatives while receiving treatment, and should be discussed with the treating doctor or psychologist.

How do I help someone who self-harms?

People who self-harm may be secretive or feel ashamed about their behaviour. It helps to talk calmly and non-judgmentally about your concerns.

Encourage the person to see a doctor or other health professional about the self-harming

Suggest options for getting help, rather than directing the person what to do

Do not hesitate to call emergency services on 000 if you think the person is at risk of serious injury

Remember that you cannot stop someone from self-harming and it is not your responsibility when they do. You can only do your best to encourage them to get help

Resources

Crisis resources

Kids Helpline 1800 55 1800

Lifeline (24-hour crisis telephone counselling) 13 11 14

Suicide Callback Service 1300 659 467

Call 000 for urgent medical attention or police attendance

Information and advice on mental illness

SANE Help Centre 1800 18 SANE (7263)

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Self-harm means any behaviour which involves the deliberate causing of pain or injury to oneself - usually as an extreme way of trying to cope with distressing or painful feelings. Self-harm includes cutting, burning or hitting oneself, binge-eating or starvation, or repeatedly putting oneself in dangerous situations.

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Accessibility of suicide-related information on the internet.

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Accessibility of suicide-related information on the internet.

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Explains research into the increase of the accessibility of suicidal and self harm content on the internet and how this can have negative impacts on youths. Give truth to the myth.
Credible source, published in the Journal of affective disorders.

Biddle, L., Derges, J., Mars, B., Heron, J.,.........& Gunnel, D. (2016). Suicide and the Internet: Changes in the accessibility of suicide-related information between 2007 and 2014. Journal of affective disorders. Volume 190, pg 370-375. doi:10.1016/j.jad.2015.10.028

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Relative to how the myth has become a youth issue.  A non credible source as it is a newspaper article. Confirms that the myth could in fact be true.

Vine, S (2014). 'The Chilling self-harm sites that drove a much love daughter to suicide': The Daily Mail. Retrieved from: http://www.dailymail.co.uk/debate/article-2541614/SARAH-VINE-My-chilling-journey-self-harm-websites-drove-loved-daughter-suicide.html

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Three minutes. That's all it took to create an account on the social networking website Tumblr and find a notice telling me how to slit my wrists most effectively; how I can make them almost impossible for doctors to stitch up.

Three minutes, and I'm plunged into a surreal world of pain, in which I see images of a young girl hanging from a noose, another hyperventilating as blood runs down her thigh, and a boy in a toilet cubicle holding a gun to his own head.

The images flicker like half-glimpsed scenes from a horror film. This world, barely a few clicks away, is at once terrifying and compelling - a uniquely disturbing combination of innocence and corruption.

Helpfully, Tumblr offers me a 'You Might Like This Too' panel alongside these images: a list of recommendations based on the photographs I'm looking at.

I click on a picture of a heavily bleeding arm, captioned: 'I hate it when the cuts don't turn out so deep.' The author of the post appears to be a pretty young girl with big eyes and blue hair.

I click on her followers. One of them posts mostly pictures of a slim girl in her underwear showing off her hipbones and 'thigh gap' - where her legs are so slim that the tops of her thighs don't meet.

Some of the images have been deleted, 'marked for review'. So someone, somewhere, is monitoring this stuff - although clearly not closely enough to censor a picture of an entire arm, scars layered upon scars, some fresh, others healing.

Next to it is a horrible photo of what looks like an infected cigarette burn.

The most disturbing image is that of a lithe young thing who has marked herself up in black pen, like a surgeon's marks on a patient who's about to go under the knife. Dotted lines outline her waist, inner thighs and underarms, with 'cut here' instructions, rather like those you might see on a paper doll. Her breasts, by contrast, are marked for enlargement.

I'm posing as a 16-year-old on Tumblr, a social networking site populated mostly by children and young adults. Set up by 27-year-old American David Karp and bought by Yahoo! for over $1billion last year, it is an internet phenomenon, with more than 200 employees.

Tumblr allows users to place photos and articles on their blogs, which others can follow. It currently has over 166 million blogs active on its site.

In five minutes, I have seen stuff that even I, a fairly worldly 46-year-old, find unbelievable. A whole universe of pain and anger and desolation that I shall not forget easily.

Can these things truly be real? Are the (mostly) girls pictured in them actually doing these things to themselves? And if so, why?

My journey began when I read the tragic story of 15-year-old Tallulah Wilson. She threw herself under a train at St Pancras Station last October, and her distraught mother explained at her inquest this week that she had found pictures of Tallulah, who had been a promising pupil at St Marylebone School in London, self-harming on Tumblr.

Tallulah's troubles started when she found herself the victim of bullying. Then her beloved grandmother died, and things took a dark turn.

Struggling with her unhappiness, Tallulah found solace by creating a fantasy cocaine-taking online persona, posting distraught messages on Twitter, Tumblr and other networking sites, and sharing her angst with fellow sufferers.

She would upload pictures of her self-inflicted injuries. She would also blog about her desperation and feelings of self-loathing. She would speak of her anorexia, and also invent wild fictions about drinking and drug-taking.

Tallulah felt rejected in the real world, so she sought validation in a virtual one, and rapidly found it. By the time of her death, she had acquired over 18,000 online followers.

Her mother, Sarah, said that she had desperately tried to keep her daughter off the extreme websites, but the teenager refused to listen.

Tallulah's online messages deepened in their blackness.

In messages posted in the months before her death, she claimed: 'I struggle with anorexia', and said she had been sent to an institution which, she implied, treated the illness.

She also wrote: 'Never ever OD again, my head is so so bad' and 'I still cant get the frikin marks off from the heart monitors at hospital'.

When Tallulah's mother contacted Tumblr and had her account shut down, her daughter was distraught. 'She started banging her head against the wall. It was horrible,' said her mother in court

One of her final messages was: 'Why the **** should I stay if no one around me stay for me? I'm done. I'm ****ing done #suicide #goodbye.'

When Tallulah's mother contacted Tumblr and had her account shut down, her daughter was distraught. 'She started banging her head against the wall. It was horrible,' said her mother in court.

It was shortly afterwards that she took her own life.

Pictures of Tallulah show a doe-like, beautiful young girl. From the outside, it is hard to see how someone like her - a loved, high-achieving child of supportive parents - could have a care in the world. It seems completely irrational.

And yet exploring the pages of Tumblr and other sites frequented by girls her age, one thing is clear: reason doesn't come into it. This is a world crackling with raw emotion, where reality - and sanity - is distorted beyond all recognition.

Most teenagers experience feelings of rejection, whether real or imagined, at one point or another. It's part of the strange and baffling transition from child to young adult.

But while many may have their anxieties exacerbated by peer pressure or bullying, not all reach straight for the blade. The dark thoughts may be there, and they may well find expression through less harmful routes: tattoos, piercings, too much eyeliner, strange music.

But for one in 12 young people, according to the latest numbers from the NSPCC, the compulsion to make their pain flesh, to write it in blood on their own skin, is too hard to resist.

Nihara Krause is a clinical psychologist who specialises in helping young people suffering from depression or anxiety. She sees a range of ages, from as young as eight to 18.

'More and more young people are self-harming,' she tells me. 'It is definitely more prevalent among girls; although when boys do it, they tend to do so more seriously. Self-harm is often linked to trauma - unpleasant or unwanted sexual experiences, for example - or to low self esteem.'

But does the internet exacerbate and escalate these emotions? Is the fact that those vulnerable to this behaviour can seek and find others like them online actually encouraging damaging behaviour? Is there a kind of virtual hysteria that sets in, where the sharing of similar sentiments leads to a kind of collective psychosis?

It appears so, as Krause explains. 'The self-harmer can feel isolated in his or her peer group and has often been bullied,' she says. 'This can make them extremely vulnerable to the lure of the internet. For these kinds of children the internet feels comparatively "safe". Here they can live out fantasies and create alternate personas to cope.

'But, in fact, [such online activity] is extremely unhelpful because these websites normalise the experience and reinforce the actions. And the extremes they portray have a de-sensitising effect: so what should be shocking no longer is.'

This feverish escalation in behaviour is certainly something I found all over the internet. In that respect, self-harming websites are unpleasantly reminiscent of pro-anorexia websites. There is an atmosphere of competition: thinner, deeper, more extreme.

I spoke to Clare, aged just 12, who had just started self-harming, in a bid to understand what drove her to such a thing.

The child of successful, happily married parents, it seemed extraordinary that she already felt such darkness. 'Parents don't understand kids like me,' she said. 'Going online and showing your scars is a bit like a club. And haters [non-cutters] simply aren't welcome. We don't need them. We have each other.'

I was struck by her depth of feeling, and how she viewed her online self-harming 'friends' as rather like a suicidal support group - only they're not trying to talk each other out of hurting themselves.

From our discussions, the idea that these sites and forums 'normalise' what is far from healthy behaviour certainly rings true.

It's perhaps one of the most disturbing aspects of my online journey. I found, for example, a discussion about how best to conceal a blade. The tone of the girls is so matter-of-fact, so practical, they could be discussing any number of innocuous subjects and not, as they are, how best to facilitate self-mutilation.

Of course, self-harm is not a new phenomenon. A girl who went to school with me used to do it, and I know of at least two women roughly my age whose grown-up daughters did it in their adolescence.

But what is new is this online community of self-harmers - which doesn't just include cutting but also burning, pulling out hair and, to an extent, anorexia and bulimia.

They seek validation through each other's actions, and each 'like' or 'share' or 'I heart this' comment online encourages them to take their behaviour one step further.

I also spoke to 15-year-old Angela, who has been cutting herself for several years. Pretty and highly intelligent, she has already left one school because of bullying. Again, she has a warm, supportive, family.

'Self-harm makes me feel alive,' she says. 'But I also do it when I'm feeling bad - when I want to punish myself.'

Clare agrees with this feeling of self-admonishment. 'I did it because I felt so angry with myself,' she says.

Perhaps one of the reasons more girls tend to self-harm than boys is because boys are generally much better at externalising their anger. A boy will kick a ball around, or grab a rival by the scruff of the neck. When boys bully, it tends to be physical, bigger lads picking on smaller ones, or those they perceive as weedy or different.

Girl bullies are different. They mess with each other's heads, playing a ruthless game of mental torture with their victims. And girls internalise their suffering, blaming themselves for their failures, rather than their environment.

Angela agrees with this, describing her feelings with a tragic poetic eloquence. 'That's what self-harm is all about: turning on yourself, punishing your body. I turn my flesh into a canvas for my inner suffering.'

There is also no question that self-harming is a cry for help. Many of the posts that I encountered online referred to the fact that parents and teachers didn't seem to notice or care.

As one self-harmer wrote: 'She got quieter, her nights got longer, her blades got bigger, her cuts got deeper, her sleeves got longer - and no one seemed to notice.'

The question of what can be done to protect our children from themselves is a complicated one.

When I first embarked on this journey, every cell in my body wanted all these pages shut down immediately. Tumblr in particular, where a lot of the action seems to take place, seems to have a criminally blase approach to the situation, with little evidence of monitoring.

Type self-harm into Google, however, and the immediate search results at the top of the page are pretty impeccable: NHS resources, Childline, the Royal College of Psychiatrists.

These days, by contrast, children grow up in a confusing and frightening world where their young minds are exposed very early on to all sorts of traumas, thanks to the largely uncensored stream of information that the internet brings through all our front doors

So the problem is not the same as that of pornography - almost certainly because, unlike porn, there is no money to be made from self-harm.

The more I delved, the more I realised: there is only one person who can really protect my own young daughter from this stuff - and it's me. As both Clare and Angela tell me, the spark that encourages this epidemic of self-harm is their access to the internet.

It makes sense. Think back to when you were a child. You would go from home to school and back again with little awareness of what was going on outside your immediate sphere. I know I did.

And not only was I physically shielded from the worst aspects of humanity, I was mentally shielded too. Sure, certain big issues penetrated my bubble; but I didn't have to address the really serious stuff until I was mature enough to process it properly.

These days, by contrast, children grow up in a confusing and frightening world where their young minds are exposed very early on to all sorts of traumas, thanks to the largely uncensored stream of information that the internet brings through all our front doors.

Even for an adult, the relentless stream of negativity, the seediness, the disturbing images which can be chanced upon online, are wearing. Is it any wonder that it can send some fragile young minds over the edge?

As parents, we have a duty to protect and shield our young from the darker aspects of humanity until they are of an age to cope.

The internet is simply no place for a child to be on his or her own. It is an environment where the naive and the vulnerable have no protection, and where, as the tragic story of young Tallulah shows, darkness can all too easily take hold.
Names have been changed. Any child who has a problem can call ChildLine on 0800 1111. Harmless helps those who self-harm and their friends and families.

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The chilling self-harm sites that drove a much loved girl to suicide

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Three minutes. That's all it took to create an account on the social networking website Tumblr and find a notice telling me how to slit my wrists most effectively; how I can make them almost impossible for doctors to stitch up.