Not all kids who self-harm, ie; cutting, are at a conscious risk to themselves. In fact, most of the time they are NOT suicidal or trying to actually hurt themselves. It is a coping mechanism that parents often don't understand. When parents learn of it, they often panic and seek immediate help. No problem with that, it is a natural reaction. However, they are likely to be told that their child is not at risk to his/her self. Many might then choose to accept it as best as they can, albeit uncomfortably, and hope that it is a phase that their child will eventually tire of.
***Note - There is much to self-harming that I will not go into, because I am not a medical professional. If you do have a child who self-harms - do seek professional help so that your child can try to learn other methods of coping. ***
But what do we do when our self-harming child IS a risk to her self? During the crisis modes, so that our child is still able to be in the home, without the need for hospitalization?
1. Utilize our crisis support team
There are agencies who specialize in crisis evaluation in the home. While there may be times that our child is only safe in a hospital setting, not all crisis' need to result in that. With the help of professional crisis clinicians, we have the support in determining if our child requires hospitalization, before spending sometimes days in the ER waiting for psychiatric evaluations.
Our crisis team doesn't just come out in crisis moments, they also maintain regular home visits to help reduce things from reaching that point at all. We rely on our support team, and they rely on us - all for the common goal of helping our child.
2. Keeping harmful objects and "triggers" locked up.
It is important for us to remove certain things from our child's sight. In order for her professional team to feel safe about her being at home during crisis times, we must do our part to ensure her safety. And we must do so willingly. Removing everything from the walls, because we should no longer have push pins, nails, screws, etc. visibly showing and/or easily accessible, is NOT a sacrifice nor inconvenience. If that will help keep her here with us at home, versus being at a hospital, then we have no problem with it. In fact, I very happily removed everything myself. There isn't a single bit of decor that we would rather have in our home than our children.
Removing the items is only part of it though - it is imperative that these things be secured, either in a locked room or in a lock box. Currently, we have everything sharp (including kitchen knives, scissors, as well as the before mentioned wall hangers) locked up in my bedroom. My room is kept locked at all times that I am not in it. I carry the key with me at all times I am not in my room. I am not real satisfied with this current arrangement though, only because I don't like restricting access to any part of our home that I might be in from any of the children. To remedy this, I will be getting a lock box so that everything is secured and out of sight, without restricting her from coming into my room.
Some of the minor challenges to these safety measures are keeping constant vigil that sharp objects are immediately returned when needed to be used. It means coming up with alternative methods to hanging up decor. We are in the process of using double-sided tape and non-sharp hanging supplies. It is taking time and for now, most of the walls are bare, but her smile is much more beautiful than any painting or decor item.
3. Securing and administering medications.
Just as it is important for her safety to have all sharp items secured, it is additionally vital that we secure all medications. ALL medication that is in the home is also secured in my locked room. It is up to me to ensure that medication is given at required times, and doses. I cannot just hand them to her and walk away. I am now her nurse, when needed, as well as her guardian. It is my job to stand there and visually verify that she has taken the medication. I must say that she is really great about being understanding about this requirement.
It isn't just her medication that I must secure - it is the entire household medication. If you come into our home and you have medication and/or sharp objects in your purse and/or pockets - I am going to ask you to secure them in my room.
4. Staying up until the children are asleep
We have one teen and one elementary school child in the home. The teen is doing home studies and the younger child must up by 6:00am to get ready for school. The teen is rarely able to sleep right away and is up past 10:00am, I require my own quiet time while waking up before getting the younger one up, so am up by around 5:00am. This makes for short nights and long days. Too much of this can render me exhausted and less effective at ensuring our child's safety. It is up to me to make sure that I have a break, if needed, to take advantage of the days when we don't have to be up early and give myself those extra couple of hours of sleep. Because I MUST be the last one to bed, if I am to ensure the safety of our child here in the home. I can nap, but not in my unlocked room. So, I nap on the couch, where I can still hear any comings and goings, and our child is able to have easy access to me if she needs anything.
5. Developing a regular routine.
This is a struggle for all of us. We have been a family of working odd hours and schedules, which led to irregular routines. But it is very important for a child's mental well being to have a regular routine. It is especially vital if there are any anxiety issues. A structured environment, with regular schedules, helps greatly to ease much of the daily anxiety and uncertainties. It is hard for any child to feel secure when they don't know what to expect each and every day. For a child who sometimes struggles with life, it is even harder to get through each day without some kind of structure.
6. Having a scheduled "Family-Time".
Nowadays, with electronic devices and other factors - there seems to be somewhat of a disconnect with family interactions. This was true for our family. Oh, we would do things together, but not on a regularly scheduled basis. We now have a scheduled time, from 6pm-8pm, that is family time. It is a family rule that dinner is eaten together during this time. Each family member has one assigned evening that is "their" night. They get to choose the meal and activity for that night. Participation in each night's activity is not mandatory, however each of our presence is. Even if everyone is sitting around on personal devices, it must be done in the same room. Rarely, has anyone sat out an activity. We are finding that we actually enjoy our time together. Sometimes, picking an activity is almost as much fun as the actual activity itself.
This is vital for both the kids' socializing and feeling a part of a family unit. It helps alleviate depression and brings us all closer together.
7. Most importantly.....
It takes love, dedication, determination, and belief in ourselves that we CAN ensure her safety. It is knowing that there are days that we are exhausted, but will continue to get us all safely through another day. There are days that we must be warriors in our fight to keep her safe, safe from herself. Some days, the battle is harder than others and we must not give up. There is no room for uncertainties - we must ensure that we are able to do this with no doubts. We must know when to call for help. That includes calling for help when we are unsure if it is required. There are no quick fixes or overnight cures - this is changing every one of our lives in both small and large ways. We have to recognize that this is a long-term commitment that we are making. Our child depends on our strength while she is learning how to develop her own.
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