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What to look out for
Nadia: Next, I want to take some time to share some insight around assessing risk, and outline a few potential warning signs that we, as young people, think that you should keep a lookout for. We’ve put together these indicators that young people may display, that could suggest that we’re at risk of harming ourselves. These have been taken from our own lived experiences.
Number 1: we tell you we are! This is the most obvious, but most important one.
Number 2: we attempt to hide risk objects or evidence such as scars. But, be careful not to assume we’re doing this unless there are other reasons or signs to suspect it.
Number 3: there are sudden changes in our behaviour. For example, becoming suddenly very positive or compliant.
Number 4: the use of phrases around being tired, or exhausted, or not wanting to be awake anymore. These can be used as euphemisms for feeling suicidal or not able to cope safely.
Number 5: we are dismissive of ourselves, our emotions, or things that have happened to us, maybe using phrases like, “It doesn’t matter.”
Number 6: we act or speak in a mechanical, flat or robotic way.
Number 7: we show significant loss of control over our emotions. For example, crying hysterically over a long period of time.
Please bear in mind that this is not a comprehensive checklist. Not everyone will present in the same way, so always treat the individual in front of you.
Lastly, here’s one example from my life which shows these warning signs in a real situation:
So, there was one occasion when I was in my teens, when I was quite actively suicidal and very unsafe within myself. And I called the crisis line, after having a really bad episode
that left me very distressed, and the worker on the phone wasn’t very concerned with what I was saying and wasn’t able to offer me much to help with the situation. So, I felt like my last option had failed, and decided to go through with my plan.
I showed the warning signs, like becoming very suddenly positive, and just trying to end the conversation, and I was able to eat that night for the first time in quite a few weeks.
I was also very calm and able to write my intentions down. However, thankfully, someone intervened and I was kept safe that time.This wasn’t always the case, though, and the next time I was very suicidal, despite being known to services, I was hospitalised after an attempt.
Let’s work together to make sure that young people in crisis like I wasare safer in the future.
The video included a list of indicators that young people may display, which could suggest that we are at risk of harming ourselves. Examples included ‘they tell you’, ‘attempt to hide scars’, ‘become dismissive’ and ‘Sudden changes in our behaviour without discernible reason – especially becoming suddenly very positive and compliant’. These have been taken from personal lived experiences of young people accessing crisis support.
The indicators reflect the various methods/ways; verbal, behavioural and physical, young people can communicate risk. This is why it is important to be welcoming, observe body language, ask questions and practice active listening throughout the conversation.
Please bear in mind that this is not a comprehensive checklist, not everyone will present in the same way – so always remember to treat the individual in front of you as a unique human being. We want these indicators to supplement what you learn in your clinical risk training. They come from our lived experience.
Nadia, one of the young advisors, shared some personal experience which highlights these warning signs in a real-life situation. It shows how spotting these indicators aids timely intervention and keeps young people in crisis safer.
You can have a second listen/refer to Nadia’s personal experience between 01:48 – 03:19
Reflecting on Nadia’s experience: what are some of the indicators you have encountered or usually encounter? What other indicators have you learned from clinical risk training that are not covered here?
Things to avoid
We’ve compiled this list to give you an idea of some of the behaviours, phrases and language that are unhelpful when a young person needs support from you in a mental health crisis. Some of these are going to seem obvious but we do hear about them happening quite a lot, and young people wanted these things communicated with you.
Don’t make promises you can’t keep. Be clear from the beginning on what you can and can’t do.
Don’t just say that things will get better. Instead, acknowledge our feelings and validate what we are saying.
Don’t try to avoid questions and skip around a topic – It really helps us when you are direct.
Don’t assume that the physical is a representation of the mental – in all areas, trust what we are telling you. We heard from a lot of young people with eating disorders who had been judged on their weight. This is not helpful and ignores the person, only focusing on their body. Mental illness can be hidden behind many physical symptoms, not just injury.
Don’t say ‘just stop’ – we might not have control in that moment.
Don’t tell someone they can’t be helped, or that they’re too complex for help. Instead, remind us that you are here for us and that you hear us.
Don’t treat us like a child. We may be young, but we want to be taken seriously and treated with respect. Don’t belittle us or talk down to us.
Don’t argue or shout at us. Sadly, young people did report receiving this behaviour when reaching out for support. We know that sometimes we can seem ‘difficult’ but this usually means we are afraid and deeply distressed. Treat us kindly.
Don’t be defensive, but work with us to defuse situations.
Sometimes we feel pressured to approach a service or person when we don’t feel ready. If this is the case, don’t double up on that pre-existing pressure but give us time to open up. Let us know that we are in the right place and that you are glad we have reached out.