A Short Introduction to Understanding and Supporting Children and Young People Who Self-Harm

I was really excited to read this book – comprehensive information about adolescent self-harm is more crucial than ever, given the increased number of disclosures being made to people who often feel out of their depth with knowing how to help. The book is aimed at anyone who cares about, or works with young people but has a special emphasis on parents and carers. Fitzpatrick has more than 30 years’ experience in child psychiatry and this is obvious from the way she has written and communicated her knowledge.

A lot of the information given clearly comes from someone who has dealt with a lot of top-end-spectrum self-harm. While this is perhaps useful for others in the same field, it did make for uncomfortable reading at times and would not be appropriate for everyone – but on the plus side, it covers a lot of ground in seemingly few pages.

In the early chapters there is a lot of emphasis on linking self-harm and suicide, which was disappointing, especially as opinion is so divided on this matter. The examples provided of deliberate self-harm include cutting, overdoses, hanging and strangulation, which is a pretty brutal introduction to the subject matter and perhaps a reflection of the author’s top-end experiences rather than the more moderate self-harm that is generally encountered. In my view this would not be suitable reading for parents or carers, who will already have fears of their own and would benefit from a much softer and more reassuring approach.

The book covers a lot of ground, but would perhaps have benefitted from being more specific and going into more detail in places. For example, less than a page is given over to looking at why young people self-harm, which is often the thing parents want to know the most about. The advice about treatment is very medicalised, with an emphasis on accessing formal services for a variety of therapies and includes a section on involuntary hospital treatment.

I would have preferred to see a more holistic, child-centred approach encouraging the reader to talk to the young person and find out what they want rather than coercion into services. Equally, I’m disappointed that the internet is underestimated as a source of help, when many websites can be of benefit to all concerned – this would have been a great opportunity to encourage browsing together with your young person as a way to start communicating about the issues.

I think this could be a useful book for professionals looking for a starting point, but in conjunction with other material to provide a balance of views. I would discourage parents and carers from reading this because I feel they would benefit from something more sensitive to their specific needs. It has the potential to be a great book, but has left me feeling frustrated.

Reviewed by Rachel Welch, project director, selfharm.co.uk