Resources

Asking for help

When it’s time to talk about your mental health

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

Find out who’s best to talk to

You might already know who you want to talk to, perhaps a parent or a teacher you get on especially well with. If you’re not sure who to talk to then it’s worth thinking about who you trust and feel comfortable talking to. Have you talked to someone who has been particularly helpful before?

Think about what you want to say

Whilst you may have made the decision to talk to someone, you still need to decide what you want to tell them. You might want to think about:

  • Is there a problem you need to talk about?
  • How much are you happy to share?
  • How do you feel each day?
  • What has prompted you to ask for help now?
  • Is there anything you are finding hard to manage?

Practise saying what you need to say

It’s alright to be nervous, so it’s a good idea to prepare. It sounds a bit strange but you’ll feel much more confident talking to a parent or teacher if you’ve worked out what you want to say and tried saying it beforehand.

You can start by writing down bullet points, writing a text or using a free online resource called Doc Ready… You could give this to someone to read if you are not yet comfortable to talk.

It’s worth writing a list of what you want to say to take with you so you don’t forget anything. You could formulate your words into a letter, both to help you work out what to say and also as a back- up. That way if you find yourself unable to talk about your issues you could give the letter to the person you’ve chosen to talk to instead.

It’s ok to start small and say ‘I’m not having a good day’.

A good next step is to call an anonymous helpline (see ‘Sources of advice’ for local helplines) and practise talking to someone you don’t know – that can be easier than talking to someone you know and care about and can help you whilst you get ready to take the next step.

Find a quiet time

Make sure you start the conversation at a time when the person you’re talking to won’t be interrupted and has time to listen to you properly. It’s important not to rush the conversation. If they can’t talk now, it doesn’t mean they don’t care about you; ask them when would be a good time to talk and come back then.

Take it slowly

Don’t feel like you have to say everything in one breath, or even in that first conversation. Take it nice and slowly and don’t be afraid to pause to think about what to say next.

Don’t over-analyse their reaction

It’s perfectly normal to try and second guess what the person you’re talking to is thinking. You might have all sorts of ideas about what is going through their mind, but don’t try to second guess. They might be surprised, and thinking of ways and routes to help. Try to ask them rather than just guessing.

Remember that there are other people to talk to if the conversation doesn’t go as well as you hoped.

It’s okay to cry

However you react, it’s ok. It’s natural to cry or feel angry. None of these feelings are a bad thing.

Know your rights about confidentiality

If you talk to someone who you know through their professional role, one of the first things they’ll do is to tell you that they can’t keep confidentiality. That’s because they’ll need to ensure you get the support you need to help you to get on top of things.

You can talk to them about who needs to know what – but try to remember it’s a good thing that people understand what’s going on so they can help you, though it might seem a bit scary at first.

Think about what you want to happen next

It’s a big step to ask for help and it usually means that on some level you’re ready for things to improve. Do you have any idea of what you might like to happen as a result of the conversation you’re planning? This might include:

  • Support telling parents or a friend
  • First aid or medical help for injuries
  • Support to help you talk through and overcome underlying issues
  • Referral for specific treatment that you’re already aware of (or learn more about possible available treatments)
  • You’re not sure, you just can’t carry on with how things are

Even if you’ve gone looking for help, it can be hard to accept it – but try. Have faith in the person you’ve confided in to help you to take the first steps to make things better. They won’t be able to fix everything all in one go, but they can work with you to start to make things change.

“When I first started talking I realised I wasn’t so alone”

“From the moment I took that brave step I felt very much less alone.”

“I thought it was weak to ask for help, but I realised eventually that it was the ultimate sign of strength.”

“You’re not alone. Reach out… let yourself be loved.”

“Although it can be hard to take a first step there is help out there”

Sources of advice (Hong Kong)

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 2896 0000

Samaritan Befrienders Hong Kong 24-hour hotline: 2389 2222

Suicide Prevention Services 24-hour hotline: 2382 0000

Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777

Hospital Authority Mental Health Direct hotline: 2466 7350

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 9088 1023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 2777 8899

Resources

No Harm Done: Recognising and responding to self-harm

Next steps for staff working with young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

INTRODUCTION

Self-harm describes any way in which a young person might harm themselves or put themselves at risk in order to cope with difficult thoughts, feelings or experiences. It affects up to 1 in 5 young people and spans the divides of gender, class, age and ethnicity. As such, many people find themselves in the position of wanting to support a young person who is self-harming. This can be difficult due to lack of confidence or uncertainty about what to say or do. Here we’ve provided simple guidance for taking those first steps – your support can be life-changing.

“I was so alone and lost and desperate. I thought no one cared until my [social worker] encouraged me to open up. I remember that day so vividly – it was the first day of the rest of my life.”

SELF-HARM WARNING SIGNS

There are many signs you can look out for which indicate a young person is in distress and may be harming themselves, or at risk of self-harm, the most obvious being physical injuries which:

  • you observe on more than one occasion
  • appear too neat or ordered to be accidental
  • do not appear consistent with how the young person says they were sustained

Other warning signs include:

  • secrecy or disappearing at times of high emotion
  • long or baggy clothing covering arms or legs even in warm weather
  • increasing isolation or unwillingness to engage
  • avoiding changing in front of others (may avoid PE, shopping, sleepovers)
  • absence or lateness
  • general low mood or irritability
  • negative self-talk – feeling worthless, hopeless or aimless

“At first we thought he was just accident prone, it was easy to miss, he always had an explanation as to how he’d got hurt.”

THE FIRST CONVERSATION

The sooner we encourage a young person to disclose their self-harm, the sooner we are able to provide or seek appropriate support to help them break the cycle. We can do so by passing our concerns on to a [trusted adult/teacher] or by providing a safe space for the young person to talk to us.

“It was the hardest conversation of my life, but every word I spoke made the load feel a little lighter and for the first time in a long time, I felt hope.”

The most supportive first conversation is one where:

  • the young person is the sole focus of your attention
  • you spend most of your time listening, not talking
  • the young person tells their story, you never guess or assume
  • there is a feeling of acceptance and support, not judgement
  • self-harm is not dismissed as attention seeking
  • unrealistic promises are not made about confidentiality
  • this is recognised as the first step of a difficult journey
  • clear next steps are identified and followed up promptly
  • you recognise how hard this conversation must be for the young person
  • you respond calmly – even if you don’t feel calm

“I’m not looking for attention, it’s just the only thing that helps me control the wayI feel.”

WHEN A YOUNG PERSON ISN’T READY TO TALK

When a young person is more reluctant to disclose or discuss their self-harm, three important questions to consider are:

  1. Who is the best person to have this conversation? You can use your knowledge of the young person, or ask them who they feel comfortable talking to.
  2. How can you help the conversation flow? An informal environment or talking whilst carrying out another activity such as walking or drawing can really help.
  3. Would another medium work better? Some young people feel happier talking via instant messenger, text or email – be creative and use your knowledge of the child.

“I tried several times to talk to him to no avail; it was only when I texted him that the conversation finally started.”

If a young person still isn’t ready to open up, provide them with details of anonymous sources of support and regularly revisit the situation.

“The [phone] counsellor helped me get more comfortable talking about things and next time my teacher tried to talk to me, I felt ready.”

NEXT STEPS

If you have any concerns about a young person’s immediate safety, this is an absolute priority and should be treated as an urgent safeguarding issue in line with your policies. If you think a young person is at risk, they should not be left alone.

All discussions should be recorded and shared with a trusted adult/teacher who will keep these details on file and can provide support and direction on appropriate next steps. These might include:

  • Informing adults who need to know in order to keep the young person safe. This will usually include parents or carers.
  • Visiting the GP to seek further support and guidance.
  • Providing access to a school counsellor.
  • Setting up regular meetings with a trusted adult such as a class teacher who can provide practical support and guidance.

It is important that all wounds are appropriately dressed and cared for as infection is common. Provide the young person with information about wound care or access to a trained first aider or medical professional who can assess and dress any wounds.

“He didn’t want to show me his wounds but he was happy to have the school nurse assess and dress them as long as I told her not to ask any questions.”

PROVIDING PRACTICAL SUPPORT

If you find yourself in the position of providing regular support to a young person, here are some helpful things you can do:

Listen – provide a safe space for non-judgmental, supportive listening. Even a few minutes of high quality listening can make a huge difference to how supported a young person feels.

Address stressors – work with the young person to understand their triggers and stressors. Working

through a typical day and highlighting the tough bits can be a great way to start and then think creatively of ways you might address these.

Make a self-soothe box – work with the young person to collect a range of different things they can use to distract or soothe themselves when they feel the urge to self-harm. This might include music, colouring, books, bubbles, photographs or inspirational quotes.

Provide safe sources of further information – highlight sources of further information such as those listed at the end of this resource.

Safeguarding your own wellbeing – It can be emotionally challenging to support a young person who is self-harming so it’s important that you too receive regular support and confidential listening. Keep in regular contact with a trusted adult/teacher and if, for any reason, you feel you are unable to continue to support the young person, discuss this at the earliest opportunity.

“Things changed for me at home and I felt unable to provide the level of support she deserved. I was honest with her and we identified a different adult she could regularly speak to.”

WHOLE SCHOOL APPROACH

Whilst there is much that proactive, supportive individuals can do to help a young person within their school or organisation, this support is best provided within the context of a whole school approach in order to keep both ourselves, and the young person as safe as possible. Simple steps that your school could take include:

1. Developing and implementing a mental health policy

Clear guidance can give staff the knowledge and confidence they need to respond to issues appropriately. It is important to develop a policy that feels relevant and achievable within your setting and to ensure that all staff know who to refer to with concerns.

2. Providing training for all staff

Providing basic training for all staff on how to recognise and respond to self-harm will increase the confidence of both staff and students in making and responding to disclosures.

3. Addressing self-harm as part of the curriculum

Your school curriculum can provide a great opportunity to tackle myths and misunderstandings surrounding self-harm and to provide students with an understanding of how to keep themselves and each other supported and safe.

4. Looking after staff wellbeing

Before we can look after others, we must first look after ourselves. Supporting young people who are in emotional distress can be physically and mentally draining for staff; this needs to be recognised and appropriate support put in place, both in terms of training and supportive listening.

“Most importantly, the [professional training] day got us talking about self-harm. It was uncomfortable at first but we all grew in confidence throughout the day. It was really empowering – we’re no longer scared of disclosures, we feel confident we can help.”

FURTHER INFORMATION (UK-only)

YoungMinds: youngminds.org.uk Parents Helpline 0808 802 5544 (Monday to Friday 9.30am – 4pm)

YoungMinds provides information and free resources to help implement a whole school approach and self-harm, mental health and resilience training for professionals.

Charlie Waller Memorial Trust provides free self-harm training to staff working with young people.

Factsheet from The Royal College of Psychiatrists Childline: childline.org.uk 0800 1111 (24hr)

Helpline (24 hr): 08457 90 90 90 UK & NI

Email: jo@samaritans.org The Site: thesite.org

Self-Harm Alternatives: over 130 ideas for use in recovery suggested by young people, collated by Dr Pooky Knightsmith

Self-Harm and Eating Disorders in Schools: A Guide to Whole-School Strategies and Practical Support by Pooky Knightsmith. Available as a paperback or Kindle

A Short Introduction to Understanding and Supporting Children and Young People Who Self-Harm by Professor Carol Fitzpatrick. Available as a paperback or Kindle

No Harm Done:    film &     resource pack for parents

No Harm Done:    film &     resource pack for young people

“There’s no denying that it’s a gruelling journey and there are downs as well as ups; but once you’re out the other side and you see a happy, healthy young person ready to head out into the world it is the best feeling ever.”

Resources

Seeking help for anxiety

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • Why seek help for anxiety?
  • Who to talk to
  • Treatment available

It’s important to get treatment for anxiety

Anxiety is physically and emotionally exhausting. Getting help early means you can start to get relief and recover sooner. There are many professionals who treat all kinds of anxiety.

There is a wide range of effective treatments for anxiety, e.g.

  • Cognitive behavioural therapy (CBT)
  • E-mental health tools
  • Relaxation techniques
  • Medications

There are also lots of things you can do to help yourself.

Often, it’s a combination of things that help us get better, such as:

  • A well-informed health professional you feel comfortable talking to
  • The right psychological and medical therapies
  • Support from family and friends
  • Exercising and healthy eating
  • Learning ways to manage challenges and stress, such as structured problem solving, meditation and yoga

How do I know it’s anxiety?

Severe anxiety can appear in ways that feel like other health issues, e.g.

  • Chest pain
  • A racing heartbeat
  • Dizziness
  • Rashes

Sometimes, anxious people think they’re having a heart attack.

When we’re anxious, we can also become hyper-aware of:

  • Our body
  • Aches and pains
  • Perceived threats and danger

Sometimes, once we’re aware of a problem, we can become ‘hyper-vigilant’ in checking on all the discomforts and pains we feel. This can spiral into feeling more concern and worry, making the anxiety more severe.

You should always see a doctor, so they can make a thorough check of your symptoms and rule out any other medical condition.

Who can provide help for anxiety?

As well as your doctor, there are other health professionals who can help with anxiety, including:

  • Psychologists
  • Psychiatrists
  • Counsellors
  • School and university counsellors
  • Social workers and occupational therapists trained in mental health
  • Mental health nurses

What type of treatment is available?

There are three broad categories of treatment for anxiety:

  • Psychological treatments (talking therapies)
  • Physical treatments (medications)
  • Self-help and alternative therapies

Psychological therapies are the most effective way to treat and prevent the recurrence of most types of anxiety. Depending on the type of anxiety, self-help and alternative therapies can also be helpful. They can be used alone or combined with physical and psychological treatments.

A thorough assessment by your doctor is needed to decide on the best combination of treatments for you.

Psychological treatments

Psychological treatments can be one-on-one, group-based or online interactions. Psychological treatments are sometimes called ‘talking therapies’ as opposed to ‘chemical therapies’ (i.e. medications).

Keeping health in mind

Talking therapies can help us change habits in the way we think, and cope better with life’s challenges. They can help us address the reasons behind our anxiety, and also prevent anxiety from returning.

There are a wide range of psychological treatments for anxiety, including:

  • Cognitive behaviour therapy (CBT)
  • Exposure therapy (behaviour therapy)
  • Interpersonal therapy (IPT)
  • Mindfulness-based cognitive therapy
  • Positive psychology
  • Psychotherapies
  • Counselling
  • Narrative therapy

Some of the above treatments can be accessed online. Evidence-based online treatments can be as effective as face-to-face treatments. These online treatments are often referred to as e-mental health programs.

Physical treatments

Your doctor should undertake a thorough health check before deciding whether medication is a good option for you. Taking medication for anxiety must be supervised by a doctor. If medication is prescribed as part of your treatment, your doctor should explain the reason for choosing the medication they’ve prescribed.

Your doctor will:

  • Discuss the risks and benefits, side effects, and how regularly you need check-ups.
  • Advise what treatments can work together with the medication, such as psychotherapy, lifestyle changes (e.g. exercise) and other support options.

Anti-anxiety medications are used for very severe anxiety in anxiety types such as:

  • Panic disorder
  • Generalised anxiety disorder (GAD)
  • Social phobia

Anti-anxiety medications, such as benzodiazepines, can:

  • Be addictive
  • Become ineffective over time
  • Have other side effects such as headaches, dizziness and memory loss

Anti-anxiety medications are not recommended for long-term use.

It’s important to know that not all anxiety needs medication. Many people respond well to lifestyle changes and psychological treatments.

Self-help and alternative therapies

There are a wide range of self-help measures and therapies that can be useful for anxiety. It’s good to know that there are things you can do for yourself to feel better.

Self-help and complementary therapies that may be useful for anxiety include:

  • Exercise
  • Good nutrition
  • Omega-3
  • Meditation
  • De-arousal strategies
  • Relaxation and breathing techniques
  • Yoga
  • Alcohol and drug avoidance
  • Acupuncture

Different types of anxiety respond to different kinds of treatments. Severe anxiety may not respond to self-help and alternative therapies alone. These can be valuable adjuncts to psychological and physical treatments.

e-mental health programs

e-mental health programs can be used in conjunction with a mental health professional or as a stand-alone option. e-mental health programs (also called ‘e-therapies’ or ‘online therapies’) are online mental health treatment and support services. You can access them on the internet using your smartphone, tablet or computer. The programs can help people experiencing mild-to- moderate depression or anxiety.

Some e-mental health tools, such as myCompass developed by the Black Dog Institute, have been found to be as effective in treating mild-to- moderate depression as face-to-face therapies.

e-mental health treatments are based on face-to-face therapy, positive psychology and behavioural activation. These therapies mainly focus on reframing thoughts and changing behaviour.

Key points to remember

  • Lots of professionals can help you with anxiety
  • There are many types of treatments for anxiety, and you can get better
  • Many people who have had anxiety have been able to seek help and live active, fulfilling lives

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more Information and Support

Black Dog Institute – “myCompass”

Student Health Services – “Understanding Anxiety Disorders”

OCD & Anxiety Support Hong Kong

Mind Hong Kong – “Anxiety and Panic Attacks”

The Mental Health Association of Hong Kong:

Phone: 2528 0196
Website: www.mhahk.org.hk



Resources

Helping someone who has a mental illness: for family and friends

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • How to tell if someone has a mental illness
  • What to do if you are concerned about a family member or close friend
  • How to behave with someone who is depressed
  • What to do if someone is suicidal
  • Self care for carers
  • Key points to remember
  • Further information and support

Someone with a mood disorder is like anyone with any other illness – they need care and support. Family and friends can provide better care if they are informed about the illness, understand the type of treatment and are aware of the expected recovery time.

How to tell if someone has a mental illness

Even if you know someone well, you will not always notice when they have changed. You are more likely to notice big or sudden changes but gradual changes can be easy to miss. It’s also true that people will not always reveal all their thoughts and feelings to their close friends and family.

For these reasons, family and friends cannot expect to always know when someone has a depressive illness and should not feel guilty that they ‘did not know’.

The best approach is to acknowledge that mental illnesses are common and to learn how to recognise the signs and how to offer help.

What to do if you are concerned about a family member or close friend

If you are worried that a family member or close friend has a mood disorder, try talking to them about it in a supportive manner and either suggest that they consult their doctor or another mental health professional.

Sometimes they may be reluctant to seek help. You might need to explain why you’re concerned and provide specific examples of their actions or behaviour that are worrying you. Providing them some information such as a book, fact sheets or helpful pamphlets might also help.

You could offer to assist them in seeking professional help by:

  • Finding someone that they feel comfortable talking to.
  • Making an appointment for them on their behalf.
  • Taking them to the appointment on the day
  • Accompanying them during the appointment if appropriate.

This level of help may be particularly appropriate if the person has a severe mood disorder such as psychotic depression or mania.

Young people, adolescents in particular, are vulnerable to mental health problems. If you are concerned about someone, try:

  1. Gently let them know you have noticed. changes and explain why you are concerned
  2. Find a good time to talk when there are no pressures or interruptions.
  3. Listen and take things at their pace
  4. Respect their point of view.
  5. Validate what they are experiencing, but don’t offer reassurance or advice too quickly
  6. Let them know that there is help available that will make them feel better.
  7. Encourage them to talk to a doctor or other health professional, and to find a trusted friend or family member that they can confide in.

There are also a range of services (e.g. telephone counselling and online resources) that are specifically designed for young people. You can find out more about what is provided in Hong Kong on the Coolminds website.

How to behave with someone who is depressed

Patience, care and encouragement from others are vital to a person who is experiencing depression. Someone experiencing depression is very good at criticising themselves and needs support from others, not criticism.

Clear and effective communication within the household or family is also important. Partners or families might find it helpful to see a psychologist during this time for their own support.

An episode of depression can provide an opportunity for family members to re-evaluate the important things in life and resolve issues such as grief or relationship difficulties.

Some Tips:

  • Avoid suggesting to the person that they “cheer up” or “try to get over it”. This is unhelpful as it is likely to reinforce their feelings of failure or guilt.
  • Another important part of caring is to help the treatment process – if medication has been prescribed, encourage the person to persist with treatment and to discuss any side effects with their prescribing doctor.
  • The person may also need encouragement and help to get to their therapy appointments or complete any online therapy exercises they have been asked to do.
  • During a depressive illness, counselling or psychotherapy often results in the person working through their life events and relationships; while this can be difficult for all concerned, friends and family should not try to steer the person away from these issues.

What to do if someone is suicidal

If someone close to you is suicidal or unsafe, try:

  • Talking to them about it and encourage them to seek help.
  • Remembering that if someone is feeling like their life is not worth living, they are experiencing overwhelming emotional distress.
  • Helping the person to develop a safety plan involving trusted close friends or family members that can keep the person safe in times of emergency.
  • Removing risks (e.g. take away dangerous weapons or items if that person is angry or out of control and threatening to disappear).

Self care for carers

(A carer is someone who provides support to a friend, family member, or neighbor in need of help because of their age, disability, or physical or mental health.)

  • Carers are also likely to experience stress. Depression and hopelessness have a way of affecting the people around them.
  • Therapy can release difficult thoughts and emotions in carers too. So, part of caring is for carers to look after themselves to prevent becoming physically run down and to deal with their internal thoughts and emotions.
  • Treatment has a positive time as well; when the person starts to re-engage with the good things in life and carers can have their needs met as well.

Key points to remember

  • If you are worried that someone is depressed or has bipolar disorder, try talking to them about it in a supportive manner and suggest that they see a mental health professional.
  • If they don’t want to seek help, explain the reasons for concern and perhaps provide them with some relevant information.
  • Young people are particularly vulnerable to depression.
  • Patience, care and encouragement from others are all vital to the person who is depressed.
  • If a loved one talks of suicide, encourage them to seek help immediately from a mental health professional.
  • Depression can take a toll on carers and close family members – it is important for these people to take care of themselves as well.

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more help and support

Bilingual Web Resources

Mind Hong Kong – “Am I A Carer?”

Mind Hong Kong – “What Can Friends and Family Do To Help?”

Student Health Service – “Understanding Depression”

Student Health Service – “Emotional Health”

English-Only Web Resources

Reach Out: a web-based support for adolescents

Headspace online: help for young people

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 28960000

Samaritan Befrienders Hong Kong 24-hour hotline: 23892222

Suicide Prevention Services 24-hour hotline: 23820000

Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777

Hospital Authority Mental Health 24-hour Hotline: 2466 7350

Social Welfare Department Hotline: 2343 2255

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 90881023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899


Resources

Self harm + young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au

Self-harm is when someone deliberately hurts or mutilates their body without meaning to die, although death may still occur as a result of the self-harming behavior.

Self-harming is a behaviour and not in itself a diagnosable mental disorder. Self-harm often occurs in young people who experience depression, anxiety, behavioural problems (such as conduct disorder) and substance use.

Facts about self-harm:
  • Not all people who self-harm are suicidal, but it can be a sign that they are thinking of suicide.
  • Self-harm often begins during youth and can be a way of communicating how bad someone feels or a method of coping with intense pain or distress.
  • Around 1 in 6 young people have engaged in self-harm at some point in their lives and around 1 in 15 during a 12-month period.
  • Support and treatment can help a young person learn safer and more helpful strategies for managing their distress and increasing their coping skills.
  • Treatment for an underlying mental health problem (e.g., depression, anxiety) can also help in reducing or stopping self-harming behaviours.

What to look for?

There are many different types of behaviours that can be considered self-harming. The most common behaviours include self-cutting (e.g. cutting of upper arms/wrists/thighs) and self-poisoning (e.g. deliberately swallowing excessive amounts of prescribed or illegal drugs). Young people may also engage in self-burning (e.g. using cigarettes or lighters to burn the skin).

There are other behaviours that are not formally considered to be self-harming behaviours but are “risk-taking” behaviours that can lead to personal harm. Some examples are train-surfing, driving at high speed, illegal drug use, or repetitive unsafe sexual practices despite knowing about safe sex practices.

What causes self-harming behaviours?

People self-harm for different reasons, and sometimes it can be difficult to put the reasons into words. In many instances when someone engages in self-harming behaviour, it is an attempt to relieve, control or express distressing feelings. Some people who self-harm may not know other ways of telling people about their emotional pain, and some may feel a sense of control over pain when they self-harm.

Research suggests some people are more at risk of self-harming. This includes people who have experienced emotional, physical or sexual abuse, or stressful and highly critical family environments, or experience mental ill-health, such as depression.

People self-harm for different reasons, and sometimes it can be difficult to put the reasons into words.

What can young people do if they are engaging in self-harm?

Try to talk to someone about it. Telling a trusted adult can help to make sure the young person is safe and that medical assistance is received, if needed. If a young person repeatedly engages in self-harming behaviours, it is best to get some psychological treatment (counselling). One aim of counselling is to help the young person to feel better and find safer and more helpful ways of coping. Young people who are having suicidal thoughts should see a professional or call their local hospital or a help line, such as Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777 or Hospital Authority Mental Health 24-hour Hotline: 2466 7350. (For more Hong Kong hotlines please refer to ‘Further information’ section at the end of this article.)

Counselling usually involves helping to increase problem-solving, communication and coping skills. Sometimes this can take time, so it’s best for young people to keep at counselling even if they think it’s not helping the first couple of times. It can be difficult to accept counselling after self-harming because of feelings of guilt, anger, or shame. Trying to be open to counselling or support can assist young people in feeling less overwhelmed and stressed in the long run.

Helping a young person who self-harms

Some people just stop self-harming, others can continue in a way that minimises physical risks, and others can place themselves at risk of dying. Even when self-harming behaviours stop, young people can experience long-term consequences associated with shame, guilt or coping with physical reminders, such as scarring. The best way to help someone you know that is self- harming is to encourage and support them to seek professional help as early as possible, to try to prevent longer-term consequences and to get the right help for any underlying mental health problems. Some things to do are:

  • Try to help the young person feel safe to discuss the self-harm.
  • Try to remain calm and maintain an open attitude recognising the young person may feel ashamed of their actions.
  • Don’t be critical or get angry when discussing these issues.
  • Ask the young person whether they feel suicidal. Call your local hospital or mental health service if you think the young person is suicidal to get professional help. Remember that someone’s risk does not always stay the same, so it is best to check in with them regularly.
  • Supporting someone who self-harms can be a stressful experience and getting support for yourself is also recommended.

Really worried?

Initial treatment involves dealing with any immediate medical complications of self-harm, if present. Call an ambulance (999) or take the person to the accident and emergency department of the nearest hospital if the person needs urgent medical attention.

The best way to help someone you know who’s self-harming is to encourage and support them to seek professional help.

The best way to help someone you know who’s self-harming is to encourage and support them to seek professional help.

Advice and referral

If you know a young person who is repeatedly self-harming and you are not sure what to do, contact someone with experience in this field and discuss the situation with them.

If a young person refuses referral for further support, you need to discuss your concerns with them. Family members may find it helpful to let the young person know that they respect the young person’s wishes, but that they also care about the young person and need to discuss their concerns with a professional.

Workers need to explain the boundaries of their relationship with the young person and the limits of confidentiality. If the young person continues to be at risk and requires more care than the worker feels capable of providing, the worker should discuss the situation with a colleague and refer to a mental health professional or service.

Further information

For further information regarding mental health, or for information in other languages, visit:

Australia / International

Hong Kong

Bilingual Telephone Hotlines 

  • Samaritans Hong Kong 24-hour hotline: 28960000 
  • Samaritan Befrienders Hong Kong 24-hour hotline: 23892222 
  • Suicide Prevention Services 24-hour hotline: 23820000 
  • Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777 
  • Hospital Authority Mental Health 24-hour Hotline: 2466 7350 
  • Social Welfare Department Hotline: 2343 2255  
  • Chinese-Only Telephone Hotlines 
  • Youth Outreach 24-hour hotline service: 90881023 
  • The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899 

Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.

Resources

Mental health problems in children and young people: guidance for parents and carers

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

Looking after a child or young person who has emotional or mental health problems can be very hard. You may feel challenged, isolated, scared and deeply upset and wish you knew where to turn for help.

What is this leaflet for?

This leaflet offers guidance on how best to support your child and where to find further advice and help with their mental health.

Be assured, things can improve for your child. Mental health, like physical health, is relevant to all of us, including children and young people. Problems are often temporary and, with support, can change for the better.

Seeking help

You are not alone. Many parents and carers have similar concerns and stresses, although they may not feel able to discuss them openly. There is good support and guidance, through national and local organisations. On the back of this leaflet is a list of reliable organisations that offer information based on sound evidence. Do have a look to find out which sources of support might be best for you.

The sooner you seek help, the better. Every local area is different but the three places listed below are a good place to start.

Talk to your GP

Your GP will listen, begin to understand your child’s needs and suggest the most appropriate course of action or support for your child, including referral to mental health specialists, if necessary.

So, make an appointment for your child and explain your concerns when you do so. You might also find it helpful to make a second appointment with the GP, for yourself, to discuss the “ripple effects” of your child’s difficulties on the rest of the family.

“[I spoke] about my hopelessness and sadness to a teacher, who called my Mum, and arranged for us to see my GP. A year later, I have just turned 16 and am in a completely different place to where I was a year ago.”

Help at school

School is an important part of the picture when it comes to children’s mental health. It’s a good idea to stay in communication with the school about the issues your child is experiencing. There may well be sources of help and support within the school, so do encourage your child to talk to a trusted teacher or member of support staff.

“The younger generation will hopefully grow up where mental health is not something that is ignored but something that should have everyone’s attention.” Teacher

Integrated Family Service Centre

Funded by the Social Welfare Department, IFSC’s are located all across Hong Kong. You can approach to receive support for your child, young person of family. Their social workers can provide counselling services or refer you out to a psychologist if necessary. You can call 23432555 to locate the IFSC for your family.

What you can do to help your child

As a parent you can have a crucial role in your child’s recovery. The more you can understand about mental health and your child’s difficulties, the more confident you will be in supporting them. Getting professional help can be important but there is a great deal you can do as a parent too. Every case is individual, but these general tips might help you to help your child:

Encourage them to talk

Try ‘open-ended’ questions like, “How are things for you?” “What’s happening with you?” “What do you think or feel about…?” or “What’s on your mind?”, rather than questions that have “yes/no” answers.

When discussing their problem, don’t try to ‘fix’ it. For the most part, young people simply need to know you are there to support them.

Listen and be understanding

Listen calmly and try not to judge your child. Let them know you are happy to listen while they chat about anything and everything, whenever they want to. Never underestimate the importance of being an attentive, non-judgmental listener.

Remember, you don’t need to know all the answers, listening without responding is often enough.

Give your child reliable self-help information from trusted sources, based on sound evidence

They can read and use this at their own pace, allowing them some privacy, but at the same time you are showing you are there to help and they are not alone. Peer-to-peer support can be really useful. Self-help links include:

Tell them, and show them, how much you care and how important they are in the family

It is not easy when stress levels are high, but a peaceful, loving home life can really help recovery. Keep family routines as normal

as possible and do simple things together – maybe watching a film, or having a meal, going for a walk or playing a game. Just doing simple everyday things together (like grocery shopping or cooking) can provide a really helpful distraction. This can bring everyone in the family closer.

Enjoy the time you spend together but understand that it might be a while before your child starts enjoying activities again. Try not to pressurise them and, if they need a little space, support them with that while not leaving them isolated.

Understand the problems

As with physical health, there are many different ways of experiencing mental health issues. Try to read up on your child’s specific problems. This will help you understand their experiences and what helps recovery, building their confidence for the future.

Encourage social contact with friends and family

Encourage your child to go out (if only for short periods) and to keep in touch with friends.

Simple physical activity

Taking regular exercise, such as going for walks, can help improve mood and reduce anxiety.

Know that recovery will not happen overnight

As a parent or carer, you want to make your child feel better immediately but, like physical health problems, mental health problems can sometimes take time to improve and some, such as eating disorders, may be complex and seem illogical. There will often be ups and downs in recovery.

Don’t be afraid to seek further advice from mental health professionals

Many of them have a great deal of experience and are generally an excellent source of guidance and support.

Don’t blame yourself

Parents or carers often feel guilty, thinking they have caused the problems, perhaps through genetics or the home life they have created. Usually, this is not the case.

Look after yourself

In order to support your child, you need to stay strong and well yourself. Often it helps to talk to someone, so don’t be scared about doing this, with friends, family or a parent helpline. For further resources and support for parents please visit the online helplines and resources on www.coolmindshk.com

Hong Kong organisations which help parents

Mind Hong Kong provides information and advice on a range of mental health topics, as well as a community directory of available resources.

New Life Psychiatric Rehabilitation Association provides a Family Support Service. They aim to build a holistic support network among carers to support them to face challenges with a positive mindset and to maintain family functions.

Caritas Family Crisis Support Center (in Chinese only) aims to manage family crisis at an early stage by providing integrated and easily accessible services to assist individuals or families in crisis or distress. Services provided include 24-hour hotline service (18288) and short-term emergency accommodation.

Youth Outreach (in Chinese only) has a 24-hour hotline for young people from ages 8 to 18. The organisation also provides support through emergency accommodation, individual and family counselling, academic and career advice, among others.

Hong Kong Eating Disorders Association
In addition to patient support groups and members gatherings, they host small group gatherings for caregivers to share and de-stress.

Baptist Oi Kwan Social Service has a family resource and service centre providing support and counselling for families of those recovering from mental illnesses.

Christian Family Service Centre provides education, counselling, groups, shelter and other services to children and families. They aim to help overcome family problems, provide quality learning environment, and build up their mutual support networks.

International organisations which help parents

Young Minds is an excellent source of information about all aspects of child mental health, including a Parent Helpline.

Minded for Families provides free, quality- assured advice which is easy to understand. It is helpful for any adults caring for children or teenagers with mental health problems.

Beat gives clear advice on all aspects of dealing with eating disorders, including helpful guidance to parents, carers and families.

Anna Freud Centre – a leaflet about mental health for parents of young children.