University of Guelph offers Self Harm Outreach Online

University of Guelph is promoting yet another mental health initiative. This one aimed at individuals who want to end their own self-harming behaviours.

Stephen Lewis is an assistant professor in psychology at the University of Guelph. He is  collaborating with McGill, Nancy Heath (McGill) to provide a social media component of support to those who self-harm.

One in four youth have self-harmed at least once. One quarter of those have self-harmed more than once. Half of those who self-harm attempt suicide. The Ontario Injury Data Report found that, between 2007 and 2009, rates of intentional self-harm leading to ER visits were 147.4 per 100 000 in Waterloo and 153.8 in Wellington-Dufferin. The provincial rate for 2007-2009 was 111.2 per 100 000.

As the following graph indicates, rates of self-harm have been declining over the last 7 years.

 

 

 

 

 

 

There were 88 emergency department visit for intentional self-harm per 100 000 Ontarians in 2009. There has been a 24% decrease over the last seven years.

Statistics from the Ontario Injury Data Report:

Waterloo 2007-2009

 

 

 

Wellington-Dufferin 2007-2009:

The following tool was also used to find statistics relevant to this blog post:

Health Indicators Interactive Tool

In the news:

Self Harm Outreach – Guelph Mercury April 03 2012

Related Sites:

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5 Elements of Motivational Interviewing

Motivational Interviewing

The goal of motivational interviewing is to help the person become ready to change and help the person move through the stages of change. The person’s views are important. There is equality between the person supported and the person being supported. Persuasion plays an important role. Support is essential, both for where the person is at and where they are ready to move. A variety of strategies is also a key component for success. The acceptance of ambivalence is paramount. Ambivalence is weighing the pros and cons. It is an indecisiveness an uncertainty. Uncertainty means that the person has not fully committed to negative thought or behaviour. In that respect, it is a matter of time and appropriate persuasion before the person fully commits to the positive change.

5 Elements

  1. Express empathy – Use reflective listening. Acceptance facilitates change. Understand that ambivalence is normal and necessary. Explore ambivalence. Look at ambivalence in your own life how you are ambivalent. Ask for details to provide empathy. Avoid judging and giving advice. Make eye contact. Summarise what the person is saying and how they perceive things. The goal is to understand their goals and their world.
  2. Develop Discrepancy – Recognise that the goals the person has are important and valuable to them. Identify the awareness of consequences; what will impact will their goals have? Have the person reflect on the positive and negative consequences. What do they want and how will it affect their life? Identify the discrepancies between current behaviour and the steps that will motivate change. The person should deliver the argument for change. This is the “ah ha!” moment that will ingrain motivation in the person. Identify the overall goal, then the small steps, then the barriers substance use. Explore the impact of the pros and cons of barriers.
  3. Avoid Arguments – When reluctance to change is sensed, change the subject or strategy. Labelling is not helpful. Identify the behaviour not the disorder. Talk about voices not schizophrenia. Talk about drinking not addiction. Focus on thier ambivalence, not yours.
  4. Roll with Resistance – Resistance is part of ambivalence. It is normal. It is a process that is necessary to complete the different stages of change. It is a signal that it is time to slow down. Use reflective listening. Shift back to the persons goals. Emphasise that the person is in control. Side with reasons not to change to restore balance in the relationship.
  5. Support Self-efficacy – Remind the person that they are in control. Help the person to achieve success through small steps. Rekindle optimism and hope. A variety of strategies provides hope. When a number of possibilities are presented hope is inspired.
This blog post is a summary of the following related video:
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Ignorance Is Bliss

Statistical graph showing the Pros vs the Cons...

Statistical graph showing the Pros vs the Cons over time, using the Transtheoretical Model of Behavior Change. (Photo credit: Wikipedia)

Planting the Seeds Of Change

When we look at how change happens, the effectiveness of change is often rooted in the early stages of the process. Many of the gains can begin when the person is living in blissful ignorance. Before change begins to happen, the seeds of change can be planted.

Seeing What The Person Doesn’t See

Before change can happen, a problem must be acknowledged and there must be a perceived need for change. The person has to believe that they need to change. The person has to see it. They have to know the need. They have to understand the “why” of change. Often, the person is not in a place where they are able to acknowledge the existence of a problem.

The person who is affected directly, the first person, the person at the centre of the problem behaviour is often the last person to acknowledge that the problem exists. Individuals who are not directly affected, such as family members, or close friends, are often the first to identify the problem. Unfortunately, when we see a problem, we can make things worse. In a desperate attempt to address the problem we may end up trying to coerce the person into a new behaviour.

Why Coercion Rarely Works

There is a long history of coercion that is reflected on by military, political, and psychological researchers. The conclusion, whether the problem be at an individual or international level, is often the same. Coercion has inherent weakness.

The use of coercion requires three things:

  1. actual force ability – Are you ABLE to follow through on the claim?
  2. follow through – Are you WILLING to follow through on the claim?
  3. restoration – When the credibility of authority is challenged, the authority is diminished. In extreme circumstances, authority is challenged to one of two death of the challenging agent, or complete nullification of the authority.
Authority, if it is challenged, cannot sustain itself. Authority is always about two (or more) parties agreeing on a context of relationship. We all have authority in the lives of those around us. If we use that authority in a manner that is congruent with the persons values and beliefs then we augment our authority in relation to that person. If, however, we use our authority in a manner that is incongruent with their values and beliefs, we erode our authority with that person.

6 Tips For Staying Congruent

Do

Let the person find, validate, and clarify their need. We can apply active listening techniques. Our best strategy is to wait, watch, and listen for statements that suggest the person may consider change. This can be like looking for a needle in a haystack, but however small the statement is, we capitalize on what the person is saying when they say it.

Do

Inform the person of potential risks associated with the problem behaviour.

Do

Believe that the person is pursing success in the way they believe is best. Everyone makes an effort to make their lives better. It may be difficult to understand another persons reasoning. There may be many years of stress or trauma that obscure a persons intentions, but the  effort is always there.

Do

Acknowledge their effort.

Do

Encourage the person to think, but not act. If the person is not thinking or acting to change the behaviour, then they are most likely not ready. By encouraging that the person think, we can essentially get a “foot in the door”. If we make demands towards action, we likely end up alienating the person and shutting them down further.

Don’t

Try to convince the person that they need help. If it’s absolutely unavoidable, stay assertive. Identify that you see a behaviour as the problem, not the person. Reaffirm that their choices are theirs.

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Kirby Steps Down Goldbloom Steps Up

mhc of canada

mhc of canada (Photo credit: Raul P)

Just 5 years in to his 10 year term as Chair of The Mental Health Commission of Canada, Michael Kirby has stepped down. The reason? He’s accomplished everything he set out to do as Chair. He says, “My experience is building things, not managing them when they are ongoing,” he explained. “All the goals I wanted to accomplish at the commission have been achieved.” Partners for Mental Health, will be his focus now. It begins with an anti-stigma social media initiative called Not Myself Today.

David Goldbloom, former Vice-Chair and Senior Medical Advisor, Education and Public Affairs, at the Centre for Addiction and Mental Health will take over as the Chair of the Mental Health Commission of Canada.

The Mental Health Commission of Canada has achieved several accomplishments over the last 5 years:  An anti-stigma initiative, a mental health and homelessness study in 5 major cities, a knowledge exchange and a pending mental health strategy for Canada, the first of it’s kind in the history of Canada.

Kirby notes that the inception of the Commission 5 years ago, and it’s progress since, has occurred under the direction of the Conservative government. Kirby credits Steven Harper and the Federal government with following through on commitments and sustaining the initiatives of the Commission.

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