The article below was written for the special Children's Rights Edition of the HRLC Monthly Bulletin, Rights Agenda, developed in collaboration with the National Children’s and Youth Law Centre, King & Wood Mallesons, the Human Rights Law Centre and UNICEF Australia.
DISCLAIMER: Please note that material in this Bulletin (Material) is intended to contain matters which may be of interest. The Material is not, and is not intended to be, legal advice. The Material may be updated and amended from time to time. We endeavour to take care in compiling the Material; however the Material may not reflect the most recent developments. The Material represents the views and opinions of the individual authors and the Material does not represent the views of King & Wood Mallesons, UNICEF Australia, NCYLC or the HLRC or the views of the King & Wood Mallesons’ clients.
We need to talk - the kids are not alright
“I started very young, I started when I was ten and it was a year and a half or two years before somebody actually found out and I ended up telling the school counsellor and of course, she told my parents. I know that when my mum found out that she was really, really shocked. Neither of my parents knew what to do with that kind of behavior and I didn’t know how to explain it to them in a way that would calm them down as well.”
Australians don’t talk about self-harm, they don’t know much about self-harm, and they often don't realise it is the leading cause of death amongst 15-24 year olds in this country. The 2014 Children’s Rights Report seeks to change this by recommending a National Research Agenda on self-harm. This will help us find out more information to better understand the problem and develop solutions, which is a push in the right direction for Australia.
What is the Report?
The Australian National Children’s Commissioner, Megan Mitchell, releases an annual report on how government can better protect the human rights of all children and young people under the age of 18 in Australia. These rights are listed in the United Nations Convention on the Rights of the Child, and include protections for things like health care, education and safety. Relevantly, Article 6 of the Convention states that every child has the right to life and Article 19 protects children from physical and mental harm which can be a cause of self-harm and suicide. Our government has made a promise to make sure all Australian children can enjoy these rights.
To help the government fulfil its promise, the Report focused on what needs to be done to address self-harm and prevent children from suffering in the future. The Report is based on 140 submissions the Commissioner received after asking people to share their ideas and knowledge with her, roundtable discussions she had with Australian experts in self-harm and other statistics.
What the Report says
The Report looks at self-harm from a number of different angles, including: what is self-harm, how do we talk about self-harm and how do we support Australian children?
What is self-harm?
Defining the problem is one of the big issues addressed by the Commissioner. This is because researchers and healthcare workers are currently not using the same words and phrases, which means that we can’t compare their research to gain a big-picture perspective. In particular, the Report emphasises that it is important for us to start distinguishing between self-harm that is done with or without the intention to commit suicide. This is to improve our understanding, as they are different behaviours which may require different solutions.
How do we talk about self-harm?
“There seems to be a fear if you discuss mental health on an open level, more mental health problems are going to arise in students. This is not necessarily the case. I feel it has more to do with how the material is presented.”
The Report revealed that it is commonly believed that not talking about self-harm and suicide will stop kids from doing it, by not “putting the idea in their minds”. However, the high rates of media coverage and general interaction between friends (especially on social media) means that kids and young people are confronted with the idea of self-harm on a regular basis. Keeping silent will not solve the problem.
The organisation Headspace suggested to the Commissioner that to solve the problem it was important to provide permission and a safe place for young people to talk about their feelings, reducing distress and decreasing the likelihood that self-harm will be seen as a good idea or something cool to do – a major cause of copy-cat behaviour.
“I found tremendous support on online forums. We would help each other commit to cutting less often and just share our stories and frustrations for the day. It was nice to know that there were people out there who understood, which put me in good stead when I did eventually get help at age 20.”
It is clear that suffering children want social connection – they want to talk. This is further demonstrated by the 80,142 children receiving counselling services from the Kids Helpline every year. It is hoped that the Report will provide an outlet for this need and generate chatter about self-harm, making it a topic that people feel more comfortable with.
The Commissioner’s recommendation to establish a National Research Agenda for children engaging in self-harm, with or without suicidal intent, should help efforts to understand the motivations behind self-harm. The focus of the National Research Agenda includes improving our understanding of the range of risk factors which increase the likelihood that certain children will self-harm (such as exposure to physical and mental harm). This will mean that at-risk children can be better targeted with support services.
How do we support children?
“We do not have a clear picture of suicide in this country and until we have access to that information we are limited in how we can effect change.”
The main finding of the Report is that much remains unknown about the issue, which hinders efforts to predict and prevent self-harm and suicide amongst children. However, Australia already provides some services to predict and prevent self-harm, including strategies such as “no-suicide contracts” in schools and emergency “green cards” providing guaranteed access to inpatient health care. Non-profit organisations, such as Kids Helpline, Reachout, Beyondblue and Headspace, are also making great progress in bringing awareness to depression and self-harm, but the effectiveness of these programs is hampered by a lack of funding, inadequate data and limited access to experts.
Given the seriousness of self-harm and suicidal behaviour, in their submissions Headspace and Orygen Youth Health Research Centre both stressed the pressing need to develop, implement and evaluate programs and interventions that address these behaviours in order to build a robust evidence base for effective early interventions. Headspace has recognised the need for research and development around intervention and has developed the Headspace School Support program and SAFE Minds project. These programs are based on the best research available and have built-in research and evaluation components in order to contribute to a stronger evidence base for the future; however Headspace acknowledges that more research is needed. The Commissioner’s recommendations act to provide a practical way that this future research can be funded and conducted to hopefully implement the right support Australia’s children need.
What needs to be done?
In addition to the National Research Agenda discussed above, the Report outlines two more calls to action:
- improve the data available, which will hopefully strengthen surveillance and awareness of self-harm; and
- update the Royal Australian and New Zealand College of Psychiatrists guidelines for management of self-harm in young people (last reviewed in 2000).
These goals will hopefully help to set the foundations for a national conversation, and provide the insight, education, understanding and data we need to build awareness and shed light on self-harm.
The Report highlights that we do not know enough about self-harm to be able to prevent the injury and death of children and young people who are currently suffering in silence. As a result, their rights as children and young people are at risk. We need more information, and creating a research agenda might help to bridge this gap. The practical goals of the Report will hopefully begin a much needed national dialogue, which will help us to learn, support and grow together.
Priscilla Hejtmanek and Lauren Murphy are Summer Clerks, King & Wood Mallesons.
Note: If you or someone you care about is in crisis and you think immediate action is needed, call emergency services (triple zero – 000), contact your doctor or local mental health crisis service or go to your local hospital emergency department. Other contacts you may find useful include:
1800 650 890
Kids Help Line
1800 55 1800
13 11 14
Suicide Call Back Service
1300 659 467