Category Archives: self harm

Birthday Plans

Have you ever wondered when you become an Adult and when your Childhood finishes.  Is there a date? a time? maybe a place.  I still struggle to work out whether I have succeed in growing up? But for the young people we work with that are in Care, this decision is made for them.  The choice made by law.  For many an age that is counted down from the day the Care Order is granted, and often for the wrong reasons.

This week I have supported one such Young Person as her 18th Birthday draws closer.  A likeable young woman who has been diagnosed with a borderline personality disorder.  Who as a child was sexually abused by a family friend, and neglected by her parents.  And as she grew older, developed an attention seeking personality for the emergency services.  

This Young Person frequently self harms through cutting, and tying ligatures or taking an overdose.  All of which would always be done out of hours in order to be seen by the Police or Ambulance service.  A misunderstanding of the Care that they provided, and a care that she feels that she is not receiving and craves from her parents.

With such little time left to her 18th Birthday, and a lack of engagement with the local CAMH’s Service was not leaving a lot of options for this Young Person to receive help and address her concerns, preventing her to live safely.  The reason why this is important is that at 18 she will be in a twilight age to old for Child Services and to young for Adult Services.  

In order to make these last few months in care work, I asked for a multi professional meeting to be arranged with the Young Person to be involved.  The aim of the meeting was to encourage the Young Person to develop her own Pathway Plan.  A plan of how she will successfully Leave Care.  

In arranging this meeting it gave an opportunity for the Young Person to share with her parents her feelings, about what she has been doing.  A chance for them to hear the pain she suffers and why.  An opportunity for this to be done in a safe manner, to offer support to both parents and the young person.  The advantage being that the Professionals could then add the support that they could offer to the young person and her parents.  Similar to a Family Group Conference but with less family and friends.

The meeting was fraught, and there was a lot of anger and tension from both the young person and her parents.  However, I was proud of the Young Person and noticed the confidence that I had seen develop over the months; as she spoke in front of everyone.  I also acknowledged that she remained present through out the whole meeting often listening to difficult comments about herself.  When I reminded her of this I could see a smile on her face and her confidence grow as a result.

For many young people 18 will always be too soon to leave Care, especially when support is needed.  But the level of support required is not enough for Adult Mental Health Services.  And with a shaky agreement to try group work therapy to help address issues and coping mechanism.  There was a positive outcome to this meeting and there is still time to help prepare her for what might be available post 18.  More importantly rebuild and re establish relationships with her family, that the young person holds important to her.

I know for myself at 18 I had left home, and I was looking after myself.  However, this was my choice and I had my family.  Further more my mental health was good.  For this young person it may not be as easy but she has been given the choice, and an opportunity to take the help one last time before she turns 18.  So far it has been 5 days since she has last self harmed……… 

Outcomes for Teenagers

Have you ever wondered what you could achieve with no money, no support, no back up plan, no stable home, no good attachments and a poor peer support network with little education? – You probably have not and why would or should you? This is however the average case for most looked after children and so I was not surprised by reading this article three in four teenagers in care will have criminal conviction by age 22 

Of course for many young people who are in care will be placed in stable long term foster placements and will achieve well or achieve the average.  

However, for a few young people in care multiple placements will happen.  Leaving them placed away from their own support networks, families and being asked to invest in a placement that could be ended quicker than what it took to move them to it.  

The real Social Work is the skill and experience of the worker to engage with these young people.  To recognise the attachment difficulties, to have the confidence to stay focused through the non compliance and the willingness to try a different approach to engender the trust in the young person.  Also more importantly to engage in services that may already be under pressure to cut back, or find voluntary service to meet the gap in needs.  The biggest argument will be with your own management and funding issues.  The constant review of Out of County funding can often prevent these important searches from taking place.

For one of my young people I feel I have succeeded in all of the above in a small way.  The young person had multiple placement moves, failure to engage with previous Social Workers, and attach to carers.  Regularly absconded, self harmed and often had suicidal ideation’s that on two occasions he nearly succeeded in these thoughts.  And was a regular drug user who was on the verge of a custodial sentence. 

This young person is now in a stable placement close to home. Who no longer is self harming, absconding, or having thoughts of suicide.  I have been able to support him to engage with education, therapy.  And still working with the Youth Offending Team to prevent the custodial sentence and looking at a more effective community order.  Yes a secure order was considered for him, and Yes he meet the criteria.  And there was a lot of pressure for this to happen.  But having seen the effect on his older sister who for the past four years has remained in secure.  I could not and did not want this young person to quickly follow in her footsteps.  I do feel rewarded that by not choosing a secure order that in my eyes his outcomes have improved.  The Five Key Outcomes are what we are asked to use to measure this success by, but can these small improvements be measured by these five key outcomes? I would like to think that they are.  The young person is alive and happy, but what about the long term and what happens when he turns 18 years of age.  When he will no longer be eligible for any statutory support other than After Care and two visits a year minimum until he is 21.

Lets hope that by the age of 22 this young person will not be the three in four with a custodial sentence.