Jane Z

Age at interview: 49

Brief Outline: Jane’s younger daughter started cutting herself when she was 14. She was referred to CAMHS after taking an overdose. Jane did not find this helpful, but is positive about contact with Harmless, a self-harm support organisation.

Background: Jane is married with two daughters aged 15 and 17. She works from home helping manage her husband’s business. Ethnic background: White British.

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Jane describes her younger daughter as a lovely, funny, clever child who was always helping other people. When she started secondary school she lost confidence and became unhappy. Jane took her to the GP, who advised against contacting psychiatric services but organised a mentor who helped her settle into school. Things became worse again when her grandmother died suddenly and she had difficulty sleeping. Other sources of stress included forthcoming exams, peer group pressure and ‘teenage hormones’. After a problematic family wedding Jane was told by the school that her daughter was cutting herself. The school were very supportive, and arranged for a teacher to help her, but he was not allowed to offer advice as he had no formal training. 

A few months later Jane was woken in the night by her daughter, who told her she had taken an overdose. Jane called the paramedics, who were very good, and her daughter was taken to hospital where she stayed for several days. Jane says the general hospital staff were ‘brilliant’; they spoke to her daughter like an adult and she was able to talk to them. Jane stayed with her, but later thought it might have been better if she had been advised to let her daughter have some time on her own. She feels an opportunity was missed, as her daughter was ready to accept help. Instead the family had to wait two weeks before their first appointment with the CAMHS (Child and Adolescent Mental Health Service). During this time they had no contact with health professionals; her daughter was sent home and withdrew back into herself. The family felt very fragile and vulnerable; they didn’t know what to say to other people about what had happened. Jane would have liked someone to give them advice on what to do, rather than telling them to go on as before and that there was nothing they could have done differently. She wishes she had been open with people, acknowledging that her daughter had taken an overdose when she was depressed, and that she needed their help and support. Keeping this secret has added to the pressure.

Jane says the family thought they had no choice but to go down the CAMHS route after her daughter’s overdose. She felt the approach taken by the CAMHS team was unhelpful: her daughter was asked many questions about her self-harming which Jane ended up answering as her daughter didn’t respond, and the second line of questioning was a tick-box list to identify suicide risk and possible symptoms of mental illness. The doctor also emphasised that she was only available during very limited hours. Jane felt angry and intimidated at a further appointment when it was suggested that her daughter should be admitted to a psychiatric unit. She told the doctors that their approach wasn’t working and they agreed to contact her daughter weekly by email instead. The CAMHS team wanted to prescribe antidepressants but Jane’s daughter was adamant that she did not want this. She agreed to take melatonin to help her sleep but unfortunately the wrong dose was prescribed and she was drowsy all the time until a pharmacist noticed the mistake. The family had to maintain contact with CAMHS as their GP could not prescribe melatonin.

Jane disagreed with CAMHS advice to remove alcohol and sharp objects from the house, as this would give her daughter the message that they didn’t trust her. She says a turning point came when her husband met another psychiatrist who believes that ‘you’ve got to take away the need to self-harm. You can’t stop the self-harming itself, so don’t try to…just be practical about it.’ By making sure the wounds are cleaned and dealt with sensibly the behaviour becomes ‘normal’ and not a source of shame. Jane says it was awful for weeks on end wondering whether her daughter would still be there in the mornings, but stresses that you have to concentrate on removing the feelings that make the harming necessary. She suggested that her daughter watch films at night when she couldn’t sleep, to distract her from her worries.

It was very painful for Jane when her daughter wouldn’t talk to her but she dealt with this by giving her space and doing little things to show that she cared about her. Jane and her husband have a strong relationship and have agreed to ‘put their lives on hold’ until their daughter is better. He has to focus on his business as family finances depend on this, and Jane thinks he has to distance himself from their daughter’s troubles. Their elder daughter has found it very hard to understand her sister’s behaviour and sometimes feels guilty because she resents the attention her sister receives; Jane acknowledges that she also needs support. Jane can understand her younger daughter more because she herself had problems with depression as a teenager when her father died.

The school recently advised Jane to contact Harmless, a self-harm support organisation. On their website she saw the statement ‘Self-harm is not an illness’. She values their practical, non-judgemental attitude and wishes she had seen this two years ago, as she now understands that self-harming can be a way of releasing the pressure of emotional pain and is an ‘extreme response to normal things when teenagers are going through all sorts of changes’. She thinks it would be a good idea for schools to have classes about self-harm, including how to recognise warning signs and suggesting coping strategies.

Jane says it is important for the young person to have someone they can trust to help them. Her daughter is harming less frequently now and the school are supporting her return to the sixth form. Her advice to other parents is not to force yourself on your child, but to stand back and let them take the lead, even though you are desperate to show you love them and it’s hard to allow complete strangers to do things for your child that you want to do. ‘If you’ve made the right decisions, for the right reasons, over the years, whatever happens, your child will forgive you for them.’

Jane Z talks about the risks of social networking for young people. ‘These days home isn’t safe anymore, because people can get at you twenty four hours a day’.

And, as parents, we can look at the social networking world site, from outside, and at it with a mature understanding that you have to use it and not let it use you. And teenagers know that, in their heart, and in their heads, but it is very, very difficult,  they, they kind of, it’s all very well to say, “Switch Facebook off, switch your phone off.” But, actually, they can’t because that’s the world that they’re growing up in, and I think, the generation coming up slightly behind my daughters, will live with social networking effectively. 

But these children, now, the ones, you know, maybe between the ages of, of twelve now and up to twenty five, it’s all, all of this stuff has evolved while they’re growing up, and so, they can’t look at it from outside, because it’s changed with them, and it’s changed with them growing up. So, it’s a world that they can’t live without, and, whether they want it or not, they have to live with it. So, the next generation will have the strategies to be able to do that, in a way that our generation have the strategies to, ignore it, if we want to, or use it, if we want to, to use it, rather than it using them. So, I think there is going to be this generation and this ten year age gap group, who are going to find that some of them have real, real significant problems with it. One of the thing is, you can say to a child, “Switch it off. Don’t do it.” But, they are then panicking about what’s happening while they’re not involved in it.

And the pressure of that is massive, and it’s too easy to say, “Switch it off.” It’s not possible. So, I think that was a huge bit, because then suddenly you’ve got, when, if I had problems at school, I would come home from school, and it couldn’t touch me, home was safe, and these days home isn’t safe anymore, because people  can get at you, for better or for worse, twenty four hours a day. So, we found ourselves in a position where,  things were happening through the night, that we just weren’t aware of, and, and it wasn’t, you know, I suspect in years to come we’ll find out whether there was any actual real tangible bullying going on. I don’t think there was. I think it’s just teenage pressures, and drama queen stuff, and the fact that my daughter will always try to make things right for people, and, when you hit mid-teens, the world isn’t solvable anymore. It’s not that simple. It’s all become far too complicated for that, so you try to sort out problems, and you can’t, or you create another problem as a result, and, and then it all becomes very overwhelming. 

Jane Z was afraid for her daughter but she tried not to focus on the harming.

We didn’t leave her on her own in the house at all. We did keep an eye but, you know, it’s so damaging when a young person feels they’re being watched all the time.

And feels that, so it’s really, really hard and you do go to bed every night wondering whether, when you do wake up in the morning, she’s still going to be there and it’s awful for weeks on end. But, you know, for some families, the worst is going to happen but my feeling is that you you’ve got to concentrate on removing the feelings that make the harming necessary.

You’ve got to not focus on the harming at all as a problem in itself. It’s a result of their feelings. It’s not something that the child can control at all and you shouldn’t try to make them control it. You can’t say, when they go to bed at night, “Don’t do it, don’t harm yourself tonight.” All you can say is, “Hey, you know, try and sleep, relax.”

Jane Z didn’t use the internet to look for help, partly because she was frightened by what she might see. She would have liked guidance about useful sites.

Did you find anything on like on the internet, or books, at all helpful or?

Bizarrely, my daughter has, has spent hours, I think, over the last year, trawling through all kinds of things. I haven’t, and I don’t know whether that’s a generation thing. I use the computer all the time, and I’m something of a book addict, and all the rest of it. 

I don’t know why I haven’t, and, you know, one of the first questions you asked me was whether I’d looked at your website before I came, [laughs] and, and you asked me that and I thought, “You stupid woman, why haven’t you?” And I should have done. I think, it it’s about this stupid place that you find yourself in. It’s really, really hard, to accept, that, and it’s not about not being able to accept that anybody else can help, part of me, is frightened by what I’m going to see on it, because, I actually think I’ve seen enough in my own house. I don’t need to see, I don’t know, I don’t need to see it, I don’t I don’t want to see, all of this stuff out there, because it hurts too much. So, I think, I kind of deliberately haven’t been looking.

And, I think, I felt, that the people around me should be giving me the help I need, and, I actually feel massively betrayed by the whole CAMHS experience. Because I, I don’t ask for help easily, at all, and, when somebody is sitting in front of you asking them for, for help, and you don’t give it, it’s a huge kick, huge kick, and. So, that, you kind of find yourself sitting in this black hole, and it’s quite difficult to look for help. And, so I think, I think that’s probably why I haven’t, and then you get these sort of little snippets of things, so, you know, husband accidently comes across somebody who turns a light bulb on, and you think, oh thank goodness for that.

So what sort of support and information would you have liked, and?

I don’t know, because I don’t know how I would have accessed it.

Yes.

This is the stupid, this is, it is the stupid thing about the whole thing. Because, it sounds wonderful, the website, and everything, the HealthTalkOnline and all the rest of it. But I don’t know whether I would ever have looked at it. I think if, I think if this lady in school, had said to me, “Have a look on this website.” Or had said to me, “Look on this website.” I would have done. I think, when you find yourself, drifting is too soft a word, lost somehow, in this sort of way, you need somebody to tell you what to do. So, and this is where you kind of need somebody to spot the signs, and say, “Look at this. This is where you should be looking. This is what you should be doing next.” And then all right, I’ll sit for an hour or two and I’ll work it out for myself, because that’s the way I do things.

Jane Z would have liked advice about what to say to other people. Keeping secrets added to the pressure on her daughter.

I meant to say, one of the things, the decisions that we needed help with, at that point, was what we said to people about what had happened.

And what we, what we ended up saying, was that she had, had real problems with dealing with pressure, and that sort of thing, and she’d had small, brief spell in hospital and she was going to be home and we would, you we will be dealing with it, and that sort of thing. What would, with hindsight, I think what we should have said was been quite open with people, and said what had happened, that she had she was depressed, she was struggling with pressure, she’d taken an overdose, and she needed everybody’s help, and support. 

Because, of course, then what, what we then added to all of the pressure that she was under, was the fact that she was keeping it a secret, and that is still a problem. So, those decisions, somebody has to be there, helping the family make those decisions at that point.

What are you going to tell people? And, actually, I think that almost has to be that registrar position, because, in our experience, you can’t wait for, for the CAMHS support to kick in, because it’s just not going to be there, when you need it. So, there has to be somebody sitting there right at the time, saying, “Right. This is what you’re going to put on your Facebook page, or tell your friends, when they text you.” We had a ridiculous situation, the first night, when I was sitting, I went off to get some food for us both, and came back, and my daughter was on the phone to one of her friends, and the friend had phoned to ask how she was, because she’d heard she was in hospital, and two minutes of the conversation was, “How are you?” [my daughter] said, “Oh well, I’m on a drip but I’m, you know, I’m going to be all right.” And all this sort of business, and then twenty minutes of this girl agonising about the problems about, the fact that she was currently at a party, and there was a boy there that she fancied, and he was ignoring her, and she didn’t know what to do about it, and, you know, my daughter actually sat there giving her advice about relationships [laughs]. And you think, oh for goodness sake. But, what, the fact that we weren’t open about things, at that point, meant that her friends didn’t know how to talk to her, didn’t know how to deal with her, or to cope with her, because they didn’t know what they were dealing with.

Jane Z disagreed with clinicians’ advice to remove all potential methods of harm. It implied that she didn’t trust her child, and that parents could be blamed.

Constantly, the, the CAMHS [Child and Adolescent Mental Health Service] thing, they were saying, “You must remove all alcohol from the house, and every sharp object has to be removed from the house. You must take anything that is a possible thing that she could use, to hurt herself or to harm herself, or potentially could commit suicide with.” Has anybody ever walked round the house and tried to do that? It is, it’s just not possible and, apart from anything else, what you’re doing is saying to your child, “I don’t trust you.”

“I don’t think you are capable of dealing with the situation.” And, so actually, we didn’t and, you know, she has carried on self-harming. It’s a lot less now than it was, considerably less now, and, and perhaps say now, I don’t think that she is doing it, or if so, is very occasional. You you’ve got to take away the ‘need’ to self-harm. You can’t stop the self-harming itself, so don’t try to, and one of the things that this consultant said, he said, “Just be practical about it.” He said, “Make sure she’s got plasters, and bandages, and antiseptic, and just say to her, you know, ‘just deal with it sensibly, you know. If you do hurt yourself, just make sure that you clean it up and, you know, you do this that and the other,’ and suddenly it becomes normal. It becomes like falling over and grazing your knee, and it becomes something which is open, and not being hidden.” And because that’s the other thing, it’s the shame.

Yeah. 

Of it, which is more damaging, than any of it. So, I think, you know, that sort of thing helped, but why won’t CAMHS say that to us? Why weren’t they saying that and not “remove all alcohol and sharp object from the house”? Because, basically, what they were saying to us, if you have a single thing in your house that she could hurt herself with, you are responsible for what she’s doing, and, you know, it, it’s really hurtful. So actually, we didn’t do any of the clearing the house stuff. We didn’t leave her on her own in the house, at all. We did keep an eye, but, you know, it’s so damaging when a young person feels they’re being watched all the time.

Jane Z realised it was easy for siblings to ‘get lost’ when all attention focused on the person who self-harmed.

So, I think it must be very, very easy in this situation for siblings to get lost for, for parental sort of, attention, to be absolutely on, and we’ve had angry spells with my eldest daughter, who doesn’t get angry at all, and where it’s, she feels very guilty, feeling like it, but it’s, “What about me?” You know, all this attention on, you know, everything youngest daughter wants, she gets, you know, whereas.

Yes.

“Look at me. What am I going to have?” you know, this sort of thing, and she knows why, and she understands why and she never says it, never blames, you know, but you can see, there’s a sort of, “Come on, I’m seventeen.”

Yes.

[Laughs] And she is, and she, she deserves everything in the world, and so she is putting things on hold, and she is, obviously, struggling and, she doesn’t want to worry us with her problems, and, you know, so you’ve got to keep an eye on all of the children.

Jane Z was pleased her daughter trusted her new GP enough to talk to her, but she still felt the system didn't offer help when her daughter most needed it.

We had, we had a very good sort of older male GP, who [my daughter] spoke to, who my daughter spoke to, very early on, that year seven, year eight bit. Now he was, he was a real, bit of a dour Scot, very bluff and blunder about it, practical, which was great, and he said, “Don’t go the CAMHS route, too soon for that, you know, suggest.” And, I think he was, he was the one that put us into this in-school counselling. Sort of suggestion.

Yes.

Which was the right route. When things came up again a little bit later, he’d retired and there was a young male GP who, again was very good, and he sort of said, “Look, you know, do come and see me.” But, it is this business of there has to be a trusting relationship, and, you know, young people don’t see their GPs very often, and GPs aren’t in the community the way they used to be.

Yes, yeah.

So, you don’t just go and knock on the door and say, which you did when we were younger, you know, the GP was just always about. You saw them didn’t you?

So, from that point of view, I suppose the GP just wasn’t familiar enough, or accessible enough, from that point of view. We needed, for her to do the Africa trip, to get a medical physician’s release form.

So, we did, actually, have to go to see the GP, and, obviously, my daughter was quite, was focused on going on the trip, at that stage, so there was a reason to go and do that. And we had a chat with a lady GP, who was absolutely brilliant. Because I thought, I’m going to go in here, she’s going to say, “Oh yeah, I’ll sign that. That’s fine. Off you go.” She hadn’t, and she’d actually, looked back over all of the notes before we went in. She’d looked at all of the copy correspondence that had been going on, and she just looked at [my daughter], and she said, “Blimey, this sounds like a good trip, so tell me about it.” And, we were in there for fifteen, twenty minutes. She spent time with her, and, just talked her through it, because, of course, my first impulse was, she’s never going to sign this form. And, she just sort of said, “Look, if you think you can do this, then that’s fine.” And, at that stage, I was trying to think in terms of booting the CAMHS bit as far away as possible, and I just sort of said to her, “Look, you know, one of the things that we’re really struggling with, is that we need somebody that [my daughter] can talk to.”

“If she feels that she wants to come back to you, and, and just talk things through again, is that okay?” And she said, “Absolutely, anytime.”

Great, yes.

And coming away, sort of said to my daughter, “Well, you know, what do you think? Do you think she is somebody you could talk to?” And she said, “Yeah, maybe.” Which actually was a, you know, off the top of the scale reaction, at that stage. So that, is, something, which is a kind of a fledgling

Yes.

Relationship, but again, she’s only available when you get an appointment. She’s only available, you know, restricted times a day, when my daughter is probably supposed to be at school. It’s just, it’s like the sort of the, all of the warnings that they gave us when we first went to CAMHS, it’s only there at a particular time, not necessarily when you need it.

And that’s what we need, is somebody who, you know, is there when you need it, just to off load, and say, “Look, I’m feeling really bad.” And they can respond immediately, and just say, “Yeah, and look, I’m thinking of you. We’ll talk properly in the morning.”

A nurse and doctor who talked to Jane Z’s daughter in hospital were ‘fabulous’, but Jane thought an opportunity to help her and give practical advice was missed.

We called the paramedics out. They were very good, very practical. They, she was admitted to hospital, again, A and E nurse, he was brilliant, spot on, dealt with the facts, which was the right thing to do, and I could actually see her, opening up in a way that she hadn’t done in ages. And we had, in terms of the hospital experience, because what she’d taken, she took she, she was on a drip, basically, for two or three days to try and clear things out. Unfortunately, this all came up on a Thursday night, which meant it went into a weekend, so she ended up staying in hospital longer than she should have done, because they couldn’t send her home without, a CAMHS [Child and Adolescent Mental Health Service] clearance. So, we were left waiting around for two days, basically, for that, before somebody could come out and see her, which was a, a problem. 

We had, those two first days in hospital, she genuinely wanted to go to sleep, and not wake up, and, obviously, that’s a, a massive hit for the whole family. But it’s, it was also, it was an opportunity, and if we’re talking about turning point times, that was that was the second one, and, I’m talking, eight months down the line, and I’m thinking that was a huge missed opportunity. I think that was the second time that things, could have turned around, and didn’t. So, we had an A and E sister and, actually, a registrar, who were practical, spoke to her like an adult, spoke to her as if they were listening and, she could talk to them. Somebody should have sent me away, because I, I stayed with her, and, actually, looking back, she actually needed some space on her time, on her own, whereas my instinct, as a mother, was I’ve got to be there.

Somebody should have sent me away for a bit, and given her some time on her own, so that was a look back and change things, thing. But, those two people were fabulous and I, if she could have sat and talked to, one or other of them about, and opened up at that point, she was ready to open up.

And they, obviously, they couldn’t. They’re busy and all the rest of it, you know. They, I suppose, pass on to the next person, who should have capitalised on that opportunity and that, I think, is, is where things went really horribly wrong because that was an opportunity. She was ready to talk to somebody. She was ready to accept help. She was ready to try and turn things round, and there was, obviously, a huge difficulty in how you react to a failed suicide attempt, because suddenly, you’re having to face a life that you didn’t like very much and you’re stuck with it, and you’re having to, plus the fact that everybody now knows what you did. So, there are two things there that we needed to deal with. The first thing was that, was the help that was offered, which was CAMHS, which we need to talk about. 

And then, the other sort of issue, was the decision about what you say to people, about what had happened, and you’re very fragile, very vulnerable, you’re not thinking straight, you don’t, never been there before, so you don’t know what to do. We needed somebody, as a family, to sit down and talk to, myself, my husband, my oldest daughter and say, “Right, this is what you’ve got to do.” Don’t give us any choices, just say, “Right, our experience tells us that this is what you should do, one, two three.” And, it’s like being because you are in some sort of hypnotic state basically, and you just need to be told what to do, and then you can start making decisions. Not being told to just carry on doing what you are doing, everything you do is, you know, everything you’ve done is right, you know. There’s nothing you could have done any differently and you’re thinking, “Well, there must bloody well have been because otherwise she wouldn’t be in hospital.” 

So, that sort of thing wasn’t helpful. So, we needed somebody to give us practical things to do, that was, that was one thing, and we needed the support to kick in immediately, and it didn’t.

Jane Z thought the CAMHS process made her daughter’s situation worse.

So we then found ourselves in a position where we were, telling [our daughter] she had to do what CAMHS were telling us, you know, we have no choice, and this is just going to sound. I mean it sounds ludicrous to me now that we, we went along with any of this but we did. And so we were told we had to take that route. We had this first meeting, very well meaning, you know, nice lady but just completely ineffectual and we came away from it thinking, “Well, we’ve come, we, we’ve got to persist with this because it’s, obviously, going to be a slowly, slowly approach and it’s going to take time. We’re not going to get a magic wand out, and it’s all going to suddenly be better, so we’ve just got to go along with it.” Daughter of course, came out of it thinking, “Well, that was no help whatsoever. I felt patronised.” Bear in mind, she actually wasn’t talking to us at all at the moment, at this sort of particular stage, but, we can see now, that this was how she was feeling. All the questioning, well, there were two kinds of questions, in that first meeting. The first style of questioning was, “How do you feel about what’s happened?” Okay, now, when, one of the first things this doctor said to my husband, when he talked about it was, “It is pointless asking how somebody feels. Because they don’t know how they feel, and they don’t know why things have happened, how they got here, there is no point, because all you’re doing is telling them how useless they are, and you’re putting them under more pressure.” 

So, the first line of questioning was completely stupid, as it turned out, and, so all of the questions were, you know, “What did you do? What’s happened to you? How, where have you, why have you got to this stage? You know, tell us how you feel about your grandparents? Tell how you feel about various things that have happened to you over the summer, and how do you feel about the self-harming?” And, of course, all that do, was doing was making it worse, because she was sitting there thinking she was being bombarded and interrogated by all these questions, of which she had absolutely no way of answering. 

I ended up answering most of the questions in this particular thing, and I mean I, I just found myself saying all the things as, as an adult, you learn to deal with situations and you go into game-play mode. So, you know what the social situation requires of you, and so you do what is required of you, and that’s what we did. We sat there and we answered the questions. We tried to get at what we thought our daughter might have been feeling, and so, of course, she’s sitting there thinking, “Oh okay, so that’s how they’d worked that out.” And so you’ve then got to go outside and say, “Look I’ve got absolutely no idea, but we’ve to play the game. We’ve got to.” 

So, she’s not saying anything at all to this doctor, because the questioning is just so ludicrous, and then the second line of questioning, was, was just, check-list and, when I came away and told my husband about it, he just said, “They’re just covering their backs.” It was classic, back covering, questioning. So it was, “Are you still self-harming?” And, all I could say was, “Yes, I think so.” “Do you still have thoughts about taking, ending your life?” As bluntly as that, to a child, who’s just come out of hospital and is in that sort of state.

“Do you still think that you might kill yourself?” And just a succession of these sorts of questions, and it was, it was tick-box stuff. So daughter, obviously, to the question, “Are you still thinking of killing yourself?” Sits there and shakes her head, so the box gets ticked, and they say, “Well, that’s fine. I can let you back out into the community, because you’re not an immediate risk to yourself.” 

And it was just so pointless, and, and then a list of small print stuff, “You do understand, don’t you, that we are only here during office hours. So, if you if you need any help we’re here between nine and five.” “I don’t work on Fridays so it’s nine to five Monday to Tuesday. I can be contacted by e-mail but, obviously, I’m a very busy person, so don’t expect me to reply straight away. Can’t always be accessed by phone. If you do need any help outside those hours, go to A and E.” 

Jane Z continues her story.

So, now we’re in a position where the CAMHS process is making the whole situation, not twice as bad, a hundred times as bad as it was. And actually all she needed to do was feel safe at home, and relax a little bit, and sleep, and eat, and try to become physically a little bit stronger, and then emotionally a little bit stronger. But, actually, what we’re being told is we’ve got to get her out of the house, and drag her three quarters of an hour across the town, to get her to this appointment. Anyway, we were then told that unless she attended the following appointment, they would have to be thinking that the situation was clearly an awful lot more serious than they thought it had been initially, and that they should be looking at ‘next steps’, without talking about what ‘next steps’ were. 

So, now it’s all beginning to get quite intimidating, quite threatening, and we, eventually, got my daughter back across there for another appointment. The same doctor is there, who, same approach, same questions and then the psychiatrist, who is in charge of her care, comes in, and this makes me very, very angry. We actually had two meetings with this lady, she came in part the way through the meeting, and I don’t actually even know how to describe what she did. She walked in. She greeted the doctor by her Christian name, and that was fine, this was the other thing, they always sat on the opposite side of the room to us, absolute basics, but she came in. 

She sat down. She just stared at my daughter. She just stared at her for a moment or two and just said, introduced herself, “I’m the psychiatrist in charge of your care. Tell me what’s happened to you.” And just, no kind of attempt to try and get any kind of background, or anything of that sort, and just went through the check-list of questions again, and my daughter just wouldn’t speak to her. She wasn’t speaking to either of them, at this point, just completely clammed in, petrified, absolutely petrified. …So, we had a point where, because my daughter wouldn’t speak to them, it was, obviously, more serious than they thought. And I thought, ‘think about why she’s not talking to you’. So, then all of a sudden, we’re talking, with her there, almost as if she didn’t exist, “Well, we should be looking at hospital admissions”. And this is two weeks before Christmas. “We should be looking at hospital admissions”, and so I said “well, talk me through and all the rest of it”. 

And suddenly, we’re talking about making sure that we’re not dealing with bipolar disorders, that we’re not dealing with this, that and the other, and I said, “Well, what do you mean inpatient admission to deal with this? What does that involve?” She said, “Well, it means that she’ll be taken into a unit” and they were quite blunt. No family contact. It could be the other end of the country, because we don’t know what places are available here, and it’s likely to be for a minimum of three months.” So, suddenly, I’ve got this woman sitting in front of me, telling me they’re going to take my daughter away. 

A teacher was very supportive of Jane Z and her daughter but was told he couldn’t offer advice because he had not been trained in counselling.

My eldest daughter had a, her form tutor through school was brilliant, very, very good. She was very lucky, to have his sort of support all the way through, and inevitably, he then got to know my youngest daughter as well, and, and, actually, he turned out to be the member of staff that she’s turned to. 

And I think if any single person has made the biggest difference, it’s been him. And it is back to this point of, somebody who can be trusted, who when they ask a question, the way they ask questions, the way they talk, isn’t done in a way that feels like an interrogation, or feels like being patronised, or feels as if it’s adding to the pressure. Somehow has managed to do it in a way, that is very supportive and helpful. But, his position as, as a school teacher makes that, support virtually impossible, and we’ve been incredibly lucky with the school’s approach, over the last couple of years because, actually, they’ve allowed us to, to, to make the running, to say what we need. And they have done whatever we’ve asked them to do, which has been absolutely extraordinary, and I understand, quite unusual. But they trusted us to say, “This is what needs to be done the next step. This is what needs to be done the next step.” 

But, because this one teacher has been the main point of support, and, and help, he’s obviously found it quite difficult himself, because it puts him under an awful lot of emotional pressure. And it’s difficult for him to find the help he needs, to, to do it, because he hasn’t had, had the counselling training, and all of those sorts of things. So, you know, the main support manager in school, has had to say to him, or did say to him, fairly early on in this sort of process, “You’ve got to back off. You are not allowed to give any advice.”

“You’re not allowed to offer any opinions. You can listen and, basically, that’s it.” So, actually, that’s been quite difficult, because that’s made, in some ways, the position more difficult for him, and, even though you know we can sort of say, “We, we trust your judgement, we know you well enough that the advice you’re going to offer is going to be right.” He just isn’t allowed to, and, and that’s been difficult because, when that’s the only person she’s prepared to listen to, it’s very isolating. 

Jane Z gave her daughter space and did ‘little things’ to show she cared about her.

You’ve got to not focus on the harming at all, as, as, as a problem in itself. It’s a result of the feelings. It’s not something that the, the child can control at all, and you shouldn’t try to make them control it. You can’t say, when they go to bed at night, “Don’t do it, don’t harm yourself tonight.” All you can say is, “Hey, you know, try and sleep, relax, you know, just sort of.” She eventually, instead of the trawling over the internet, all the night and, you know, and I know we had Childline calls, and that sort of thing, that, that happened in some of the worst times, and actually, some of that wasn’t very helpful, that we actually encouraged her to start watching films overnight.

And, you know, I just sort of said to her, “Look, sleep, you don’t have to sleep at night. You can sleep during the day if you want to. If, you can sleep whenever you like. But if you don’t want to sleep at night, read a book, put a film on, you know, just put your phone under the bed, or whatever.” And she, she has watched endless films over the last eight or nine months, and they are a real release and it’s, you switch off, and it’s finding the thing that your own child can, makes them feel a little bit more comfortable.

Helps them to switch off, and you know, we had several weeks, even months, where she couldn’t bear me being anywhere near her, and, as a as a mother, you’ve just got to accept that, and say that, at some point, hopefully she will come back, and if she doesn’t, she doesn’t. Actually, you’ve just got to live with that, but our experience is that, by giving them the space, and by not trying to force. So, I tried to do just little things, all the time, so if she hadn’t eaten for a while, I’d just make a cup of tea, and take a cake up, and just leave it by the bed. If she got up and about, I’d just go and make her bed, and make her room comfortable again and that sort of thing. Little things that show that you care and you’re thinking of her, but you’re not in her face all the time. 

And it takes a long, long time but, she’s trying to overcome two feelings about me as a parent. One is that she’s let me down, which no child ever lets a parent down. It doesn’t matter what they do. But, it’s that feeling of shame, and you’ve sort of got to, try to get across the idea, that they haven’t let you down without you feeling that actually, you’ve got very low expectations [laughs]. It’s not an easy one, so but you do care, and also this age group, particularly, they want to be growing up, and they want to be independent, and your instinct as a mother, at this stage, is to wrap them up in cotton wool, and hold very tight. But, that’s not necessarily the right thing to do. So, I think you’ve kind of got to somehow find a way to show, that the cotton wool is there, if they ever want it, and, eventually, come back for it. 

Jane Z suggests a unit about self-harm and how to cope with it should be part of the school curriculum.

She’s had a series of these, assemblies, in sixth form, on all kinds of issues like, you know, organ donor-ship and, all, you know, all, and they’ve been brilliant. She’s been quite inspired by all of them, and about some of these sorts of issues, but should we be doing that when they’re fourteen? Because that seems to me to be the crucial time, doesn’t it?

Yes.

Part of that citizenship bit, that they do, you know, I can’t remember what subject they call it now, don’t they, but don’t they have two or three lessons a week. And, it’s about preparation for working life, and sex education, and that sort of thing, but, you know, if it was possible to put together at a unit of half a dozen lessons, that just prepares, some of these children, because, and I know it’s mostly girls, but girls and boys about how, just to spot the warnings signs.

This is where I’m heading, and I need to stop it now, and some coping strategies, and that sort of thing.

Yeah.

Just to stop it happening, because it doesn’t have to, but anyway we’ve got this, in society, this cliché of the grunting teenager, and, you know, we got sucked into that, so, “Oh this is just the grunting teenagers’ phase.” And it wasn’t, and, we should have done something about it, and, you know, how many of those grunting teenagers are really, really hurting. So, you know, maybe that’s, that’s something practical that, you know.

Yes.

All schools should be just running a, a short unit of work in there, alongside sex education, and stuff but, just that helps. 

‘We all make mistakes’ says Jane Z. You have to ‘put yourself on hold’ and not force anything on your child.

And what advice would you have for other parents and carers?

[Laughs] We’re all, we’re all so different aren’t we? It’s, everybody is going to tell you, “it’s not your fault!” Okay, and, quite frankly, as a parent, everything your children do and feel, is your fault, but that doesn’t necessarily mean that you could have done anything about it. And, I think, if you, if you have made the right decisions, for the right reasons, over the years, whatever happens, your children will forgive you for them. So, even if you do make mistakes, and you get things wrong, because we all do, that, you know, they will come back to you.

It’s that sort of thing isn’t it, that, that, it’s very, very difficult for a teenager to trust anybody, doesn’t matter who they are, and everything, every influence around them, is telling them to ignore their parents. So, forcing yourself, on your child, is going to do more harm than good, I think. And, much as you want to be in there, and hugging, or shouting, or screaming, or shaking, or whatever else it might be, you have got to go allow your child, to, to, to sort of take the lead. My only problem, that I found, in that, is that I’m not a hundred per cent sure whether I’ve got that, completely right, because I know that my daughter now, just desperately needs a hug, but doesn’t know how to ask.

So, I’m not sure how we get over that one. I think we are getting over that one, gradually, but, the, the, the big thing about all of, how the teenager feels like this, how a child feels in this situation, is that they feel completely lost, and completely alone. So, forcing anything on them isn’t going to work. That’s just going to force them further back, into this black hole. Somehow, got to try to find a way of inviting them out, little steps by little steps, just gentle things but, that’s, that’s really hard, and you have to put your own self on hold. You’ve got to forget that, you are a person on your own, and it, and it, it’s, it’s the hardest thing I’ve ever done. To, to accept that you’re not the most important person in this at all, but you’ve just got to stand back, and allowing complete strangers to do things for your child that you want to do, is really hard.

But, you have to let that happen, but because, you do just want to hold on, and lock all the doors.