Working with whnau caring for rangatahi affected by

Working with whānau caring for rangatahi affected by suicide/self-harm Emily Cooney, University of Otago, and Clinical Advisory Services Aotearoa

Karakia Timatanga Whakataka te hau ki te uru Whakataka te hau ki te tonga Kia mākina ki uta Kia mātara ki tai E hī ake ana te atakura He tio, he huka, he hau hū Tīhei mauri ora!

Outline + Self-harm + Contagion + Internet safety + Fostering prosocial connections + Validation + Coping plans + Home safety

Context + Postvention work with communities + Communication and parenting strategies with adolescents - Self-harm - Contagion - Social media

Terms + Self-harm + Suicide + Non-suicidal self-injury + Suicide attempt

Suicide Contagion “A single paragraph may suggest suicide to 20 persons. Some particulars of the act, or expressions, seize the imagination, and the disposition to repeat it, in a moment of morbid excitement, proves irresistible”—Amariah Brigham, founder and first editor of the American Journal of Insanity in 1884” (Motto, 1967).

Learning by imitation + Modelling + Public figures + Peers + Family 7

Factors affecting the risks of contagion Direct exposure, particularly if traumatic Identification Highly-regarded person Sense of alienation Vulnerability How the event is reported and communicated

Communication factors affecting contagion +Suicide rates go up following increases and go down following decreases in the frequency of stories about suicide +The increase in suicide rates is more pronounced with dramatic headlines, prominent placement, more accepting media attitudes and more positive portrayals of those who die by suicide +Stories about individuals with suicidal ideation who used adaptive coping strategies to handle adverse events and didn’t attempt suicide are associated with fewer subsequent suicide rates

Internet safety + Education and awareness + Monitoring + Parental/caregiver controls + Connecting and co-ordinating with other parents/caregivers + Creating a culture of clean from screen time

Fostering prosocial connections + Increasing shared quality time + Insisting on activities beyond gaming and digital communication + Creating and sustaining interactions and connections that go beyond mental health issues

Validation + All-purpose human skill for fostering positive relationships + People perform and connect better with validation + Particularly important for adolescents, even if it’s often a one-way street at this time of their life

LEVELS OF VALIDATION + 1: Listening nonjudgmentally + 2: Accurate reflection: after you have listened + 3: Mind-reading: making a guess about the unspoken feelings, thoughts, or actions. + 4: Expressing understanding based on the person’s biology or past experience. + 5: Expressing understanding based on what’s accurate right now, or how people normally react + 6: Radical Genuineness: being ‘real’ i. e. open and honest in a way that’s authentic and kind 13

Shared quality time + Regular one-to-one time + Car and coffee bonding – the random parental wagging extra-curricular offsite + Warm and non-demanding contact

Coping/safety plans + What, when, who, how + Digital distraction & self-soothe kits + Self-soothe practice extravaganza

Home safety + Ensure the most lethal or preferred means are out of the house or securely locked up + Check on this, and don’t drop the topic until you have concrete evidence it’s sorted + Keep checking on it

Support for suicide prevention and bereavement + Suicide prevention co-ordinators in each DHB + Victim Support Services + Clinical Advisory Services Aotearoa + CPRS team + Aoaki Te Rā team + Kia Piki Te Ora Māori Suicide Prevention Service + Traumatic Incident Team from the Ministry of Education + The Mental Health Foundation + Le Va + https: //www. healthnavigator. org. nz/health-a-z/s/suicide-prevention/

Karakia Whakamutunga Kia tau te manaakitanga Ki runga I tēnā, I tēnā o tatou. Kia piki te ora, kia piki te māramatanga. Kia hoki pai atu, kia hoki pai mai. Tūturu o whiti ka whakamaua kia tina! Tina! Hāumi e! Hui e! Tāiki e!