Joanne

Age at interview: 44
Brief Outline:

Joanne’s daughter started self-harming at age 9, but Joanne only discovered this when she was 14. She has harmed herself in several ways and is currently a psychiatric inpatient. Joanne uses Twitter to share her experiences and understand more about self-harm.

Background:

Joanne, 44, is divorced with two daughters aged 13 and 16. She works as a part time bank clerk and cake maker. Ethnic background: White British.

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Joanne first discovered that her elder daughter was self-harming when she was fourteen. The school rang to say she was not eating and was burning herself with hair straighteners. Joanne was shocked, and her daughter revealed that she had started harming herself after she was abused at the age of eight by Joanne’s former partner. Joanne took her to the GP, who referred them to CAMHS (Child and Adolescent Mental Health Service). They were assigned a community mental health nurse, who is still involved. Joanne says she is absolutely brilliant, helping her as well as her daughter. Joanne’s daughter was eventually admitted to an adolescent mental health unit as her weight was dangerously low. Her eating disorder is no longer a major problem, but she is very disturbed and suicidal. Her diagnoses have included post traumatic stress disorder, depression, and borderline personality disorder. Joanne is hoping to get a second opinion to be sure that she is getting appropriate care. Her daughter has harmed herself in various ways, including overdoses, cutting and ligatures, and over the last two years has been admitted three times. She hasn’t been to school during this time and is currently an inpatient under section.

Joanne says that when she first found out about her daughter’s problems she was hysterical and couldn’t stop crying. She couldn’t sleep and had three months off work. She was put on antidepressants, which she still takes. She now works part-time and has an understanding employer who is aware that she may have to deal with a crisis at any moment. Joanne says she has become hardened to the situation and copes by thinking that because there isn’t any help you just have to get on with it. Now she feels quite numb and immune and can deal with her daughter’s wounds in a professional way. It has been awful for her family. They haven’t been able to go on holiday for two years. Joanne feels she has not had so much time for her younger daughter, who has to be vigilant about concealing tablets and razors from her sister. She worries about her friends and had to have time off school. Joanne’s new partner is also affected, but Joanne doesn’t tell him the full details. Her daughter’s father tries to keep in touch with her, but she refuses to see him. Joanne thinks her daughter may blame him for leaving the family and thus in some way enabling the abuse to take place. He finds it hard to cope with and can’t understand why she would want to hurt herself, though Joanne tries to explain that it is a way of relieving her emotional pain.

Joanne does not feel she has been given much help by the clinicians involved in her daughter’s care. Although the community health nurse is very good and acknowledges that parents need support, Joanne is only able to have brief chats with her. After the first admission her daughter’s psychologist left and she has been on a waiting list since. She is also on a waiting list for dialectical behaviour therapy and Joanne hopes she will be moved to a more suitable hospital if funding can be found. Joanne didn’t feel included in her daughter’s treatment at first, but now the hospital ring her after ward rounds and have set up family therapy, though Joanne doesn’t think this is helpful. She would have liked someone to tell her it was not her fault, and to give advice on what to do for her daughter. She thinks there should be much more support for siblings, and would have appreciated a group where she could talk to other parents in a similar situation. 

Joanne’s older daughter’s school was supportive, especially the school nurse, and someone from the school attended CPA meetings regularly, but the school has not been so involved recently as it is unlikely that she will return. Joanne has warned the school her younger daughter attends that she might be upset at times, and would have liked an advocate there to help her, but their attitude seems to be that if she is upset she should not go to school.

Joanne has found several websites useful. BEAT was good for the eating disorder; Young Minds is excellent and MIND is helpful for parents. She says Twitter is brilliant because she can be anonymous and talk about her daughter’s problems. She has many followers, including some young people who self-harm, who have told her it is helpful to them to see a parent’s point of view and understand what their parents are going through. 

Joanne has followed people who are self-harming, and through their explanations of why they are doing it she has gained more understanding of her daughter, who was very secretive about her behaviour. 

Joanne’s advice to parents is ‘Don’t give up. Be alert but don’t beat yourself up if your child does harm themself – you can’t be there 24 hours a day. Teenagers are secretive but don’t feel guilty about ‘snooping’. Ask for help and do your research, but just know that it’s not your fault.’ Her message to clinicians is ‘Please listen to the parents. We’re the ones who can help you to help our children. Sometimes our children won’t talk to you, but we can tell you about their background. Nobody has spoken to us enough.’ 

Joanne copes by keeping busy and putting all her effort into looking after both her daughters, who are her life. She says she’s always got hope and that’s what keeps her going. She would like to help other people so they don’t suffer like she does; she hopes to set up a parent’s support group once things have improved for her daughter.

Joanne knew about the ‘craze’ for self-harm among children but felt that her daughter’s self-harm was more about coping with problems.

Joanne knew about the ‘craze’ for self-harm among children but felt that her daughter’s self-harm was more about coping with problems.

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And did she know other people who were doing that sort of thing?

No, as far as I know, I don’t think so but I’ve since found out it is a lot more common than what we think it is speaking to the community mental health nurse. She says she’s just inundated with children that are self-harming and it’s almost as if it’s a bit of a craze but, in my daughter’s case, it wasn’t, it was not a craze. This was to help her overcome or get through the trauma that she’d been through.

So there’s, to me, there seems like there’s two forms of self-harm. There is this craze going round but there is also the very disturbed who are using it just to get through.

Young people have told Joanne that her Twitter messages help them understand self-harm from a parent’s point of view.

Young people have told Joanne that her Twitter messages help them understand self-harm from a parent’s point of view.

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I go on Twitter. I’m on Twitter and that is brilliant because I can be anonymous and I can say what she’s done and I have a lot of people following me,  who self-harm, who will tell me that it’s nice to see it from a parent’s point of view  because it helps them and they can understand what their parents are going through.

Right. Oh, that’s really interesting, yes.

Yeah.

And that’s been helpful to you as well?

Brilliant. Absolutely brilliant, yeah and a lot of encouragement as well for me as well as me encouraging the young people that are harming.

Joanne’s daughter didn’t want to live anymore. She was saved from suicide by passers-by.

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Joanne’s daughter didn’t want to live anymore. She was saved from suicide by passers-by.

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Other things she’s done is she’s taken overdoses. She’s had an overdose of it was her sleeping tablets. That was one of them. The latest one we’ve had is she took [painkillers], despite me locking everything away and having the key with me. 

She’s told us that she can’t go out the house and she hasn’t been able to go out of the house on her own but she’s still managed to do this. She did this, managed to get on a train down to the coast and took the [pills] and then was stopped from jumping off a cliff by some passers-by. So that’s why.

Gosh, yes.

She’s in hospital now. 

And why do you think she was doing that?

She doesn’t want to live anymore.

Yes.

She’s been in and out of hospital so many times that there just doesn’t seem to be a solution. 

Joanne didn’t think the local adolescent mental health unit was right for her daughter and hoped that she could be moved somewhere more suitable.

Joanne didn’t think the local adolescent mental health unit was right for her daughter and hoped that she could be moved somewhere more suitable.

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What sort of treatment is she having now? She’s in. 

She’s in hospital.

An inpatient.

She’s on a waiting list again to receive DBT therapy [dialectical behaviour therapy*].

Oh yeah.

But the problem is, she needs to go to London for that and she’s not safe enough because she’s suicidal so she’s on a section three now so, at the moment, it is just a case of we’ve just got to get her safe enough to be able to travel. We’ve also looked at moving her to a more therapeutic hospital and there is one that we’ve got in mind, subject to funding, which we hope but it is the last chance sort of hospital and they do give a hundred per cent success rate and it is more therapeutic. It is not, where she is at the moment, you’ve got all types of mental illness and it’s just not the right place for her.

It’s just like a holding place I think now. She’s beyond help for there. The psychologist that she is supposed to see is a man, which due to circumstances doesn’t help so I know that you can’t pick and choose but it just doesn’t help that she just does not want to talk to him.

Understandably because of her issues with men.

And what about the other therapeutic hospital. Do you think that’s a possibility?

Yes, we’re hoping. It’s, yes, she can’t be moved yet because she’s not safe and very, very suicidal, is always trying to run out as soon as the doors are opened.

Yes.

But they have said that they would take her even on a section three but her mental health has got to be a lot better than what it is now because what we’ve got is she’s disassociating and she’s thinking that she’s dead and that she’s not here so she’s in the depths of depression and this is one of the effects of this depression and that is what we’ve got to treat before we can make her get properly better.

* This is a form of therapy (using individual and group work) that helps the young person to learn skills to manage their emotions, cope with distress and improve their relationships. DBT helps the young person see that their suicidal and other unhelpful behaviours are part of their way of coping with problems and encourages them to develop more helpful behaviours and solutions.

Joanne’s daughter was an A star student but after she was admitted to a psychiatric hospital her education stopped.

Joanne’s daughter was an A star student but after she was admitted to a psychiatric hospital her education stopped.

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Yes, so is she at school most, when she’s not in the hospital?

No, she hasn’t been to school for two years. She was an A star student at a grammar school but no, nothing, had nothing. She does like art and she has used that to express herself but no, the education has stopped altogether.

So when she’s not in, being admitted, what, she lives here and.

She’s been here, yes. She has been going to the hospital school but only for two hours once a week but that has stopped now as well so yeah, no education, not even, she’s not even been able to do it via the internet. She’s just, it’s the least of her worries at the moment, which is a shame.

Joanne advises clinicians ‘Listen to us. We’re the ones that can help you to help our children’.

Joanne advises clinicians ‘Listen to us. We’re the ones that can help you to help our children’.

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Clinicians, listen to the parents, please, please, please. Nobody has spoken to us enough. We’re the ones that know about our children and we’re the ones that can help you to help our children so please talk to us more because sometimes our children won’t talk to you but we can tell you a lot more, especially about their background, about when they were younger, more needs to be found out about the person you’re treating through the parent, and it’s not.