SAP Newsletter

This month, we're spotlighting two important topics that often intersect in educational settings: enhancing self-harm awareness and supporting transgender youth. Our decision to combine these focuses is rooted in the significantly higher rates of self-injurious behavior among transgender students compared to their cisgender peers.

Self-harm is the action of someone purposefully hurting their body. Since self-harm does not always mean someone is suicidal, it is also referred to as “non-suicidal self-injury”. However, people who engage in self-harm can be at a higher risk for attempting and dying by suicide without intervention.

There are multiple reasons why someone might be engaging in self harm. Some of these reasons include the following:

• expressing difficult feelings, including thoughts of suicide
• reducing overwhelming feelings or thoughts
• gaining a sense of control
• punishing themselves for feelings or experiences

There are also life experiences than can drive someone to utilizing self-harm as a coping mechanism (a way to deal with difficult times in life). The experiences below are just a few examples of difficult life experiences:

• traumatic incident(s), including sexual assault or other abuse, loss of resources, etc.
• family changes, like a divorce or separation
• poverty or financial instability
• bullying
• sudden life changes (i.e. death of loved one, end of relationship, moving schools)
• school stress, including academic and peer/community pressure (i.e. friends, family, teachers, coworkers)
• low self-esteem, including body image issues
• negative feelings, including loneliness, anxiety, depression, anger, guilt, etc.
• chronic illness
• identity-based discrimination (i.e. race, gender, age, ability, etc.)

The examples above are not an all-inclusive list of possible reasons why someone may harm themselves. Please remember that their feelings are real, they aren't alone, and they can get help.

The diagram below is a brief explanation of the emotional and behavioral breakdowns of the self-harm cycle.

Some examples of self-harm may include the following:

• Using a sharp object to cut and/or pierce one’s skin

• Hitting or punching oneself or an object (e.g. wall, mirrors)

• Burning oneself with cigarettes, matches or candles

• Breaking bones or bruising oneself

The signs of someone self-harming may include:

• Scars and/or fresh injuries that can be covered by clothing

• Injuries and/or scars may be in close proximity to each other

• Wearing long-sleeved shirts or long pants, even in hot weather

• Sharing that they feel worthless or helpless

• Keeping dangerous objects on hand (sharp, fire-starting, etc.)

• Frequent reports of accidental injuries

• Unpredictable emotional and behavioral stability

Transgender youth are especially at risk for engaging in self-harm due to multiple factors. Marconi et. al (2023) says that some of these factors include:

• Lack of social support for gender identity (peers, family, school, community, state/country)
• Lack of access to gender-affirming medical care
• Health issues, including sleep problems
• Puberty (in cases of gender-dysphoric transgender youth)

The chart above is from the Trevor Project 2023 U.S. National Survey on the Mental Health of LGBTQ+ Young People. The data shows that youth (aged 13 to 17) of color are more likely to self-harm than white youth. Furthermore, transgender and nonbinary young people reported higher rates of past-year self-injury than their cisgender peers.

• Transgender boys and men: 72%
• Nonbinary young people assigned female at birth: 68%
• Transgender girls and women: 52%
• Nonbinary young people assigned male at birth: 48%

The chart below only shows data for all LGBTQ+ youth in the U.S.. Within the LGBTQ+ population, the most common motivator for engaging in self-harm was to cope with internal uncomfortable feelings, including those caused by mental illness (e.g. depression or anxiety).

The data above demonstrate that transgender youth need more community, legal, health, and additional supports to achieve an equitable level of well-being compared to cisgender youth. Some forms of support specific to transgender youth include:

• Willingness to challenge your own ideas around gender and sexual identity
• If your child comes out as trans, take time to process their identity
• Clearly express your unconditional love and support
• Considering trans-affirming medical care and providers
• Seeking resources and information from reputable LGBTQ+-focused organizations
• Helping find positive, transgender adult role-models
• Getting involved in advocacy efforts for the rights of transgender youth and adults

LGBTQ+ youth under age 21 are especially at risk of using substances. A 2022 Trevor Project report details the associated data in the chart below.

The above rates of substance use among LGBTQ+ youth varied by demographic categories. White cisgender boys and men regularly used alcohol (20%) than all other LGBTQ+ youth (9%). Native/Indigenous LGBTQ+ youth were more likely to report regular marijuana use than their White LGBTQ+ peers. Both Native/Indigenous and Multiracial LGBTQ+ youth were more likely to misuse prescription drugs compared to White LGBTQ+ youth. Nonbinary youth who were assigned male at birth reported higher rates of regular marijuana use compared to cisgender males.

Moreover, LGBTQ+ youth's experiences with conversion therapy were associated with greater odds of reporting regular alcohol use, regular marijuana use, and regular prescription drug misuse.

Identifying and addressing self-harm in school demands a collaborative approach from educators, caregivers, and mental health professionals. Creating a caring and supportive atmosphere enables schools to guide students towards managing emotional challenges more positively, enhancing their overall well-being and academic performance. Here are some tips for schools on how to respond to such situations:

1. Immediate Support: Quickly offer support to students suspected of self-harm or those with visible injuries to ensure their immediate safety.
2. Empathetic Approach: Maintain a calm and non-judgmental demeanor. Express genuine concern for the student's well-being to foster a supportive environment.
3. Active Listening: Engage in active listening, allowing the student to share their feelings and experiences without rushing to provide solutions.
4. Parental Involvement: Involve the student's parents or caregivers in the process, ensuring open communication while respecting the student's privacy.
5. Safety Plan Development: Work with the student to create a safety plan that includes strategies for coping with urges to self-harm and emergency contact information.
6. Professional Support: Advocate for the student to seek help from mental health professionals experienced in dealing with self-harm. Offer information on available resources.
7. Referral to School SAP Team: Consider referring the student to their school's SAP team. Reach out to the school if you need information on how to make a referral.

This approach emphasizes the importance of immediate support, empathy, community involvement, and safety while addressing self-harm behaviors among students.

The video below provides additional information on supporting someone who is self-harming.

What is SAP?

In Pennsylvania, every school must have a Student Assistance Program (SAP). A SAP team is made up of trained professionals like administrators, school counselors, social workers, nurses and teachers, along with a SAP Counselor from an outside agency. The SAP team is here to help identify issues that may be interfering with students' educational experiences.

How SAP Can Support Students

The Student Assistance Program (SAP for short) can support students by teaching them healthy coping skills to manage stress, practice self-care, be resilient and positive, and boost self-esteem.

How to Refer a Student to SAP:

If you are concerned about your child or a student and want to see if the Student Assistance Program Team can help, please contact the student's school administrator or school counselor.

Please check out the video below to learn more about SAP and the SAP process!

Crisis Resources:

• National Suicide Hotline: Call 988 or Text CONNECT to 741741 for free, 24/7 help

• Childline (report child abuse/neglect): 1-800-932-0313
• The Trevor Project Lifeline: 1-866-488-7386; TrevorText START to 678678
• Bucks County Mental Health 24-hour Crisis - Intervention Services: 1-800-499-7455
• Lenape Valley Mental Health Crisis Centers
• Central Bucks Area: 215-345-2273
• Lower Bucks Area: 215-785-9765
• Warm Line: 215-896-9717
• Lenape Valley Mobile Crisis: 1-877-435-7709
• St. Luke’s Penn Foundation Crisis Center - Upper Bucks Area: 215-257-6551
• Children and Youth After-Hours Emergency: 1-800-224-3869 press 2,1
• Area Agency on Aging (Elder Abuse): 1-800-243-3767
• Adult Protective Services: 1-800-490-8505
• NOVA Hotline (Victim Assistance): 1-800-675-6900
• A Woman’s Place Hotline: 1-800-220-8116
• National Domestic Violence Hotline: 1-800-799-7233 / 1-800-787-3224 (TTY)
• SAMHSA: 1-800-662-4357 - 24/7 substance abuse and mental health treatment referral and information
• Veteran’s Crisis Line: 1-800-273-8255, press 1

Self-Harm Information:

• SAMHSA on Self-Harm: https://www.samhsa.gov/mental-health/self-harm

• The Trevor Project 2023 Study Brief: https://www.thetrevorproject.org/research-briefs/self-injury-and-its-relationship-to-suicide-attempts-among-lgbtq-young-people-oct-2023/

• Marconi et. al (2023): https://capmh.biomedcentral.com/articles/10.1186/s13034-023-00654-3
  

• Young Minds (UK) on Self-Harm: https://www.youngminds.org.uk/young-person/my-feelings/self-harm/#WhydoIselfharm
  

LGBTQ+ Resources

• The Rainbow Room is an LGBTQIA youth program that provides a supportive and empowering environment for youth ages 14-21. Weekly meetings are a free and confidential place where you can learn, build support networks, and have fun. 267-282-4117 or rainbowroom@ppkeystone.org

• NAMI of Bucks County offers LGBTQ support groups; 1-866-399 6264 https://namibuckspa.org/resources/lgbtq/

• The Welcome Project PA is a non-profit organization that aims to help marginalized people in Pennsylvania feel welcome in their respective communities. They have an upcoming virtual (Zoom) training on June 4th focused on building allyship with the LGBTQ+ community. Register here!

• The Trevor Project has this guide on being an ally to transgender and nonbinary youth.

Bucks Human Services Connect - The HUB 1-888-942-8257

https://www.buckscounty.gov/1298/Bucks-Human-Services-Connect---The-Hub

The HUB aims to support families in Bucks County by connecting them to helpful resources and supports available in the community.

Bucks County Drug & Alcohol Commission, Inc.
https://www.bcdac.org/
The Bucks County Drug & Alcohol Commission, Inc. offers online resources available in Bucks County and provides information on prevention, treatment, and recovery supports. If you or a loved one is struggling with drugs and alcohol, the BCDAC is here to help!

NAMI Bucks County, PA

https://namibuckspa.org/

NAMI is the National Alliance on Mental Illness, the nation's largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.

Lenape Valley Foundation (215)-345-5300

https://www.lenapevf.org/

Penn Foundation (215) 257-6551

https://www.pennfoundation.org/

Penndel Mental Health Center (215) 752-1541

https://www.penndelmhc.org/

Family Service Association of Bucks County (215)-757-6916
https://www.fsabc.org/get-help/counseling-therapy/

*Contact the number on your insurance card for appropriate providers.*

Contact Information

Email: mgroden@councilsepa.org

Website: www.councilsepa.org
Location: 4459 West Swamp Road, Doylestown, PA, USA
Phone: 215-345-6644