I was recently at an IEP meeting at a local high school and the school staff said something that stopped me in my tracks. "Self cutting behaviors are common and are not a real red flag of serious mental health issues." I was amazed ! As I probed and protested that this statement could not be right, they dismissed my lack of credulity as being an inter-generational lapse. In effect self cutting was a fashion statement. Since that meeting these statement have been on mind. My research reveals that, just as I suspected, self cutting is an indicator of serious mental health needs and should be taken very seriously; no fashion statement here.
According to the NASP, National Association of School Psychologists, self cutting is often an effort to avoid suicide on the part of a teenager (overwhelmingly female although not exclusively) but needs to be taken very seriously by the school team:
"Incorporate RSM [Repetitive Self-Mutilation Syndrome] training into your crisis team responsibilities. Because RSM involves physical harm to a student and indicates a seriously troubled youth, responding to a student who self-mutilates should be done by members of your crisis team and handled initially as a suicide risk."
It is considered an impulse disorder but treatment for self cutting has not been well researched and there is no one established treatment protocol for this kind of behavior.
There are some positive steps that are recommended to at least try to remediate the outward behaviors which should be coupled up with other treatment modalities. These include:
- rub an ice cube on your skin instead of cutting it;
- wear a rubber band around your wrist and snap it gently against your skin;
- draw on the skin with a soft-tipped red pen in the place you might usually cut.
School people when confronted with extreme behaviors either inward, as with self cutting, or outward with acting out behaviors, often do not seem to be able to marshall the resources to address the reality of the situation. It is small comfort to learn that self cutting is not a fashion statement and in fact is, as I strongly believed, a symptom of significant mental health issues which can not be ignored. Parents who often have not confronted such behaviors before and have a limited frame of reference, can be mislead at the assurances of school staff that self cutting is not a serious behavior. According to the NASP, and other authorities, these assurances are not grounded in fact. As with all advocacy when confronted with statements that make no sense– probe, research and analyze. In this instance, your child’s life could hang in the balance.