SHERIDAN — Self-injury might not always lead to suicidal ideations, but determining the severity of those acts proves difficult. Dr. Carolyn Pepper provided physicians, counselors and other social workers with tools to help prevent acts of self-injury from continuing and transitioning into suicide attempts during an Inner Circle presentation Thursday at the Sheridan County Fulmer Public Library.
Pepper serves as a University of Wyoming psychology department professor and director of clinical training, focusing specifically on self-injury, suicide and clinical psychology. Her presentation focused on suicide statistics specifically for the Mountain West region of the United States, self-injury that may or may not lead to suicide attempts and suicide prevention.
Self-injury most commonly includes cutting or burning oneself without suicidal intent, according to a journal published by JJ Muehlenkamp and P.M. Gutierrez in 2004.
Clinicians have identified the age groups most susceptible to this type of self-harm as adolescents and young adults, although Pepper alluded to adults also causing self-injury by picking fights they know they’ll lose, aggressive behavior like punching a wall or putting themselves in compromising health situations.
Pepper did not present statistics relating to suicides recorded after a person inflicted self-injury, though she did say 35 percent of people inflicting self-injury did it for emotion regulation and 15 percent did it to communicate stress.
Pepper pointed to a notable difference in those adolescents or young adults who inflict self-injury as a means of emotion regulation versus it leading to suicidal actions.
“They keep moving to different methods and keep looking for that same sense of relief,” Pepper said. “You build up a tolerance and you move to the next method, and you build up a tolerance for that. Each time you’re moving to something more severe.”
Buffalo school counselor Jen Skaggs, who attended the training Thursday, found Pepper’s presentation refreshing, as a lot of what Pepper presented has already been implemented in the Buffalo school systems. Skaggs did find the information on method movements as a helpful tool for future assessments with students in Johnson County.
When a student is reported or self-reports crisis, whether it is self-injury, suicidal comments or ideation or another form, Skaggs and other certified counselors within the school district complete a risk assessment per the district’s established crisis protocol. The crisis protocol looks similarly to prevention treatments presented by Pepper, which included Collaborative Assessment and Management of Suicidality, suicide safety plans, cognitive therapy for suicidality and dialectical behavior therapy (DBT). DBT was first used as a treatment for borderline personality disorder but has proven to be a helpful tool for suicide prevention and other behavioral issues.
Skaggs not only works with other counselors in the district when a student presents a risk to themselves or others but also connects with parents and Northern Wyoming Mental Health Center which is based in Sheridan with additional offices in Buffalo, Newcastle and Sundance.
Skaggs feels fortunate to collaborate with such a solid group of coworkers and community outlets and believes the success she finds in her work with children can be heavily credited to that.
“I’m not having to make the decision (on how to help a student) by myself,” Skaggs said.
Non-suicidal self-injury practices are common in schools, Skaggs said, and the indicators Pepper discussed will help Skaggs with future situations.
While not all forms of self-injury lead to suicidality, Pepper said it can be prevented and replaced with positive, non-destructive behaviors.