Self-harm is not just attention-seeking: it’s time to talk openly about the issue

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attention-seeking, Bullying, causes, emotional distress, emotional pain, emotions, isolation, obsessions, pain, physical pain, professional help, relief, secret, self-harm, stress, teenagers, young people

Self-harm is not just attention-seeking: it’s time to talk openly about the issue

Three years ago, with her parents and sisters out for dinner, then-13-year-old Lucy found herself alone in her family’s Lincolnshire home. Dressed in her pink Tinker Bell pyjamas, she began to make herself a cup of tea. Then she spotted an object on the kitchen counter that immediately diverted her attention. “Shall I do it?” Lucy asked herself. “Will it stop the pain?”

For Lucy, now 17, that evening marked the start of a two-and-a-half year struggle with self-harm. Two weeks before, she had been brutally attacked and raped (which she now describes as “the incident”). At the time, anxious they wouldn’t believe her, Lucy never fully revealed to anyone what had happened. In her mind, she tried to repress the rape. She began shutting herself in her bedroom. She told her parents she was feeling unwell. Physical pain, she decided, was the only way to purge her pent-up emotional pain.

“When you keep all your problems in, it feels like you’re screaming inside,” Lucy says. “But when you cut or burn yourself, the pain is more physical. You feel like you’re releasing that scream. After a few months, self-harming became part of my daily routine.”

Eventually, both at school or at home, Lucy was self-harming four times a day. She wore black jeans, black tops and even black gloves to conceal her scars. “I pushed everyone everyone away” Lucy says. “I stopped caring about school. My grades suffered. Self-harm became a real obsession. It took over my life.”

Today, having made a huge effort to stop, Lucy has not self-harmed for more than six months. But self-harm is still on the rise among the UK’s young population. Data published last year by a collaborate study from England Health Behaviour in School Aged Children (HBSC) revealed that up to one in five 15-year-olds across the country self-harm. During the past decade, according to the same study, there has been a three-fold increase in the total number of UK teenagers self-harming.

What drives young people to self-harm? Therapist Jenna Mutlick, who has a personal experience of it, says it is usually some form of “self-punishment”. People believe they have done something wrong – even when they haven’t – and then feel they deserve the pain. “I know a few people who self-harm because they are bullied and eventually come to believe that they then deserve to be bullied,” she says. “When you self-harm, it is so hard to escape from the [mental] space that you are in.”

“It’s a very heterogeneous group of people who self-harm, and there are a variety of reasons why people might start,” says Professor Glyn Lewis, head of psychiatry at University College London. “Clearly, there are people who self-harm because they want to take their own lives, but there are also people who want to self-harm because they are in difficult situations or want to relieve stress.

“As a long-term strategy, of course, self-harm is not very effective,” he adds, “but people do report that they get some form of relief from upsetting thoughts or emotions. Some forms of self-harm are obviously very dangerous, but there’s a continuum. Some people may only scratch themselves very superficially, for example, which won’t do any long-lasting damage.”

The causes of self-harm are likely to be complex, even if the person harming does not see the issues in that way. Kieran, from Glasgow, began self-harming after five years of “constant” physical and verbal bullying at school. His parents split up when he was seven, though he says it was the bullying – which still torments him today – that incited his self-harming. “The bullying made me feel really unbalanced,” says Kieran, now 23. “I started to self-harm when I was aged 11, and it kind of just snowballed from there. I stopped eating. I isolated myself from a lot of my friends and family. I kept it a secret for almost a decade.”

Like Lucy, Kieran says that self-harming became a secret obsession. The bullying made him feel “physically and mentally numb”. Self-harm, by contrast, made Kieran feel more alive, and he would regularly self-harm in his bedroom at night. “It brought me out of my slumber,” he says. “It made me feel normal, and I became addicted to doing it for that reason.” He says that the self-harm was like an “adrenaline shot” that brings everything back into focus.”

Kieran admits that he still has a “daily battle” with self-harm. He is significantly better than he was a few years ago, though, when he would harm himself up to 400 times in one evening. “It’s a high level of emotional distress that causes people to resort to self-harming,” he says. “People sometimes feel like they can’t cope with their emotion. It’s how they cope with life’s daily stresses.”

Chris Leaman, from the UK mental health charity YoungMinds, says it is still very much a taboo subject in British society. “Every year, we work with Childline, YouthNet and selfharmUK to try and combat these sort of stigmas for Self-Harm Awareness Day,” he says. “There is a definite problem around young men not feeling like they can talk about their issues, which can make self-harm quite a common issue among them.”

“Some people do talk about self-harm quite openly, but that’s relatively unusual,” says Professor Glyn Lewis. “A lot of people conceal self-harming behaviour from their friends and family. There are not necessarily signs to look out for; it’s more a case of often asking people how they are feeling, and keeping communication open with them. As a rule, families and friends concerned about someone self-harming always should talk to the person themselves and encourage them to seek professional help.”

Statistically, teenage girls are still more than twice as likely to self-harm than young males, and this has helped create another gender-based stigma: that self-harming girls are simply seeking attention. Fiona Brooks, professor of adolescent and child health at the University of Hertfordshire, who led the investigations for last year’s HBSC report, identifies this as a prevalent problem. “Nowadays, young people are in a much more uncertain world than before,” she says. “Instead of self-harming just being dismissed as attention seeking, it’s something that needs to be taken seriously. Equally, if young girls are self-harming for attention, that’s a different matter that needs to be taken just as seriously.”

Lucy thinks back on that evening she started self-harming, and wishes that she could tell herself to stop – and talk to someone. Talking, like with most former self-harmers, has been a significant part of Lucy’s recovery, but she also credits her own determination as a decisive factor. “If you don’t want to stop, you won’t,” she says. “In the end, a lot of it comes down to how you see yourself. I used to feel people were always judging me, but now I feel I don’t care what they think. Why should I let them control my happiness?”

More than 300 rapes reported in schools in past three years

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child abuse, Children, harm, rape, safeguarding procedures, Schools, sexual abuse, Sexual Violence, young people

More than 300 rapes reported in schools in past three years

Sexual abuse in British classrooms is increasing fast, according to official figures that reveal a 40 per cent increase in reports of rape in schools in the past three years.

At least 2,865 sex-crime reports have been recorded by police between 2011 and 2013  – and more than half of them were committed by other children, according to data released to The Independent by police under the Freedom of Information Act.

The figures showed that more than 320 alleged rapes were reported in schools in the last three years, with the NSPCC saying that pupils’ easy access to online pornography has likely driven the surge in online child abuse.

Last year alone, there were at least 1,052 alleged sex offences reported in schools, of which 134 were reported as rape.

Statistics on rape and sex crime reports that took place in schools were released by 37 out of 46 UK police forces. Children accounted for more than 90 per cent of alleged abuse victims, but more than half of the claimed offences were also said to have been committed by children.

The Department of Education (DfE) has resisted calls to introduce mandatory reporting of abuse allegations but the Government is now facing renewed pressure to reform child safeguarding. Currently, headteachers are urged to report allegations to child-protection experts, but there is no legal penalty if they choose not to.

Among cases that have come to light in recent years, a 12-year-old girl was allegedly stripped naked and raped by pupils at a school in Hampshire. The school, however, believed she had consented and excluded her for breaking rules by having sex on its grounds, a tribunal heard. In May, the Crown Prosecution Service said no charges would be brought against the suspects because of insufficient evidence.

In another case, a religious-education teacher in Manchester groped and kissed a teenage pupil in one-on-one meetings he arranged in his classroom. Richard Jones, 57, started a secret relationship with the girl, but was arrested when and when her family discovered explicit messages on her computer.

He was sentenced to eight years in prison last month after admitting a string of sexual offences.

Claire Lilley, of the NSPCC, said: “Schools must make sure they have adequate safeguarding procedures in place and that parents and teachers are able to recognise warning signs early so they can take swift action when required.

“However, the damaging behaviour of these children can be turned around if caught early. Prevention has to be the key.”

The National Association of Headteachers claimed the increase in child-abuse reports may reflect “alleged victims being more confident about making a disclosure”. A spokesperson said the work being done in schools to create a safe environment was “excellent”.

But Labour called on the Government to take “urgent action”. Yvette Cooper, the shadow Home Secretary, said: “These figures are very disturbing. Schools should be a place of safety for children and young people. The Government needs to take action given the evidence of growing sexual violence amongst young people.” She added they must “introduce compulsory sex and relationship education in all schools”.

A Department for Education spokesperson said: “There is nothing more important than protecting children from harm – any allegation of abuse must be taken very seriously. Schools’ safeguarding arrangements are regularly inspected.”

Poll: nearly 50% of year 10 students feel addicted to the internet

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addiction, devices, internet, pupils, social media, social networks, students, young people

Poll: nearly 50% of year 10 students feel addicted to the internet

Almost half of all 14- and 15-year-olds feel they are addicted to the internet, with more than three-quarters of similarly aged pupils taking a web-enabled laptop, phone or tablet to bed at night, according to a survey.

Of those who take a device to bed, the bulk are communicating with friends using social media or watching videos or films, the study of more than 2,200 students in nine schools across England and Scotland found. More than four out 10 girls felt they used the internet on a compulsive basis for socialising, the survey found.

The poll was carried out on behalf of Tablets for Schools, a charity led by technology industry groups such as Carphone Warehouse and Dixons that campaigns for the increased use of iPad-like devices in education. Despite its remit the group has now published an advice guide for pupils and schools about internet devices, advising they be switched off before bed and during study times, with set times allocated for online activity.

The study said fewer than a third of students who used web devices in bed said this was connected to homework, with those more likely to use a computer, phone or laptop in bed also more likely to report feeling addicted to the internet. There were some gender distinctions, with 46% of girls saying they sometimes felt addicted to the internet, as against 36% of boys, but significantly more boys saying they felt a compulsion towards computer games.

The peak age for feelings of addiction was year 10, where pupils are aged 14 or 15, with 49% of those pupils reporting this. The greatest use of devices in bed comes a year later, with 77% of year-11 pupils. Aside from email the most commonly used sites at home were social networks like Facebook, Twitter and Snapchat.

While most students told researchers they were positive about the internet, a number expressed alarm at their apparent inability to disengage. “It’s the first thing I look at in the morning and the last thing at night. It seems I’m constantly on it,” a year-10 boy said. Another boy, a year older, said: “When I’m on YouTube one video leads to another and I cannot stop myself from watching loads of videos and sometimes I’m up till about 2 o’clock in the morning just because I’ve been watching YouTube videos.”

The issue of internet addiction is much debated, with some researchers questioning whether it can be classified as a formal addiction. There is evidence that British children spend more time online than many of their European peers. A 2012 EU-wide study of children aged 11-16 by the London School of Economics found the UK was among the worst nations for indicators of apparently excessive internet use, with more than a quarter saying they spent less time with family, friends or on schoolwork because of being on the web.

 

Teachers left to pick up pieces from cuts to youth mental health services

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behavioural problems, CAMHs, Children, counselling, counsellors, early intervention, emotional difficulties, mental health issues, mental health services, school, stress, support, teachers, training, well-being, young people

Teachers left to pick up pieces from cuts to youth mental health services

As the headteacher of large primary school in the west of England, Joan Cunningham is accustomed to the demanding aspects of managing an intake from a mainly disadvantaged area. However, for the past couple of years, she says, one issue has escalated so dramatically that it is nearly at crisis point. “There is so much more pressure on schools and teachers to deal with children’s mental health and behavioural problems,” she says. “We provide as much support as we can but, with fewer resources available and a massive increase in need … the pressure has been incredible.”

Cuts to mental health and other services for young people mean teachers are increasingly having to fill the gap, even though schools do not always have the resources or training to provide the extra support pupils with mental or emotional issues may need.

“It was already hard to access the right services before cuts but its getting worse,” Cunningham says. “Teachers … are not mental health professionals, and now there is a vacuum in the services we have [traditionally] relied on. Social services departments are under more pressure due to cuts, Sure Starts … have vanished, [and] in many cases the voluntary organisations we used to be able to turn to are disappearing. Sign-posting families to where they can get help is much harder because of all of this.” At a time when families are under greater financial strain and “even very young children” are under pressure to achieve academically, she concludes, the need for support is “growing very fast”.

Child and adolescent mental health services (Camhs) have been particularly hard hit. These specialist services assess and treat children and young people with mental, emotional or behavioural difficulties. Typically, when schools cannot offer the support of their own counsellor, or when a child has especially serious difficulties, they will seek out their local Camhs for help.

In many cases, local authorities commission and fund these services, and the impact of council budget cuts on Camhs in some areas has been severe. According to research by the charity Young Minds, two-thirds of councils in England have reduced their Camhs budget since 2010. And when the charity asked NHS trusts and councils about other mental health spending targeted at children and young people, such as youth counselling or specific services for schools, more than half had cut budgets – some by as much as 30%.

The cuts mean local authorities’ Camhs spending is increasingly redirected towards more serious cases of mental ill-health, at the expense of early intervention services. “Draining money from early intervention services is short-sighted and just stores up problems for the future,” says Sarah Brennan, chief executive of Young Minds. “The result is Camhs feels it is being asked to respond to an enormous number of issues and schools feel Camhs has left them high and dry.”

Chris Harrison, national executive member and former president of the NAHT, says part of the problem until recently has been that targets in education have allowed children’s wellbeing to slip down the agenda. “The issue of mental health [in schools] has been coming to the fore over the past four or five years; there’s a real groundswell of interest, but it isn’t yet a priority in schools. We need to accept that preparation for life is about more than academic results.”

Research by the Teacher Support Network, a charity focusing on teachers’ wellbeing, shows around half of teachers feel pupil behaviour is worsening. Its survey of over 800 teachers also found almost two-thirds were stressed as a result.

The cuts to Camhs mean schools are struggling to provide professional support on site. Some have set aside cash from the Pupil Premium to pay for a regular counsellor. Andy Bell, deputy chief executive at the Centre for Mental Health, says that an “ad-hoc” system of support relies too heavily on the initiative of individual heads or teachers, and is undermined by unsatisfactory and arbitrary access to funds. “We see raising awareness of this issue as a major priority,” he says. “When we conducted research on child behavioural problems we found that three-quarters of parents asked teachers for help … However, some schools are better equipped than others. Many have virtually nothing by way of [professional] support, while others have full-time counsellors.”

Inadequate and underfunded services mean undue stress is being put on teaching staff, who may feel they are not trained or qualified to tackle many of the emotional or mental health problems that come up.

And with anecdotal evidence suggesting the number of young people experiencing mental health problems is rising, the crisis in Camhs is set to get worse. In 2004, the last year that government statistics were centrally collected on the prevalence of mental ill-health among children and young people, 1.3 million children were deemed to have a diagnosable mental illness. The economic downturn, coupled with government austerity and exam stress, means this figure is now probably much higher. And with NHS England estimating that only a quarter of children and young people with a problem are ever seen by mental health services, the figures are just the tip of the iceberg.

Politicians are becoming more aware of the scale of the problem. The health select committee has begun a parliamentary inquiry into Camhs, which campaigners hope will push mental health in schools higher up the agenda when it is published this year. “What we need is a consistent, national system that is accountable. What we need is for Camhs to be transformed.” says Bell.

Harrison says more needs to be done to ensure heads and schools have access to effective support services. “Schools and heads are battered at the moment. We want the government to look at the evidence. It’s common sense. There is overwhelming evidence that students learn better and are more effective in environments where they are supported and their teachers are supported.”

For now, charities and campaign groups are having to help schools themselves. Young Minds offers guidance on its website for teachers and is about to pilot a helpline for school staff, while the anti-stigma campaign Time to Change is running a project promoting pupil wellbeing and offering practical guidance for teaching staff. “Pupils are under much more stress these days and so are staff, yet teachers don’t have training in mental health – or spare time,” says Moira Clewes, lead teacher on health at Sandwich technology school, Kent, one of the schools piloting the project. “We are breaking down misconceptions around mental illness. Students are opening up. Teachers are grateful for advice. You’d be amazed at the impact this is having.”

A Department for Education spokesperson points to a range of initiatives, including the MindEd website, launched in March, designed to help people working with children, including teachers, “to recognise when a child needs help and how to make sure they get it”. The Department of Health says it has a “priority” focus on children’s mental health and, among other things, has put additional cash in to “talking therapies”, adding that it is liaising with the DfE to improve links between schools and Camhs.

For Cunningham, while any help is welcome, she is adamant that “nothing short of a clear, coherent and properly funded approach nationally will work for schools and for children”.

• Some names have been changed

Self-harm sites and cyberbullying: the threat to children from web’s dark side

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Bullying, Depression, mental health issues, self-harm, social networks, suicide, teenagers, young people

Self-harm sites and cyberbullying: the threat to children from web’s dark side

“Some of the images do scare me, especially if it’s my friends. Once my friend cut lines down the side of his face as a ‘Chelsea Smile’, he put it online and it was the worst thing I had ever seen. He’s my friend, I don’t want to see him that upset. He got so much hate for it and ended up going into hibernation, nobody heard from him for over a week and we honestly thought he had killed himself.”

Frankie* is 15 and lives in the Midlands. For the past year or so she has updated her Tumblr blog most days. On other social networks she uses her real name, but on Tumblr – a blogging platform – she shares her darkest thoughts about depression, anxiety and self-harm anonymously. “The other day I put up a self-harm picture,” she says. “I was alone and in a dark place. […] Of course, nobody would help, but posting it boosted my confidence a little; finding it buried in amongst all the other self-harm posts reminded me I’m not alone.”

Fears about self-harm sites have been growing since the suicides of two teenagers who, it emerged, were obsessed with self-harm and depression blogs, with mental health campaigners and experts warning that the UK’s teens are at risk of becoming a lost generation if parents and adults cannot reach out to them across the digital divide.

Tallulah Wilson, a 15-year-old who killed herself in 2012, was caught up in a “toxic digital world”, according to her mother, while the parents of Sasha Steadman, a 16-year-old who died from a suspected drug overdose in January after looking at self-harm sites, said her “impressionable mind” had been filled “with their damning gospel of darkness”.

For the uninitiated, self-harm blogs present a surreal world of fantasy and pain. Countless sites dedicated to self-harm and depression are filled with images of bleeding wounds juxtaposed with pixelated gifs, flickering eerily with snippets of Hollywood angst. Helen, who is now 18, visited them regularly, before stopping to help herself move on from self-harming. “You have people asking you how to cut yourself deep enough because their therapist said it wasn’t bad enough,” she says. “I have had people tell me to kill myself. I think the most traumatic is when you find someone’s suicide note online and there is no way to actually get in contact with the person.”

Isolated and lonely, she used the blogs because they gave her a sense of belonging. “You want to find people who are similar to you. That is what humans do,” she says. “It starts off as trying to help, but then it becomes competitive and dangerous. You get sucked into this world of who can cut the deepest/be the skinniest and avoid notice by the outside world. You end up spending hours a day searching these sites for reassurance, but it just makes it harder.”

Keeping children safe online is the “child protection challenge of this generation”, according to Peter Wanless, head of the NSPCC. ChildLine, part of the organisation, registered an 87% rise in calls about cyberbullying last year, a 41% increase in calls about self-harm, and a 33% increase in calls about suicide, with the biggest increase among 12- to 15-year-olds.

While the internet provides unprecedented opportunities for young people to communicate and learn, it can be a dangerous place for vulnerable teenagers, says Sue Minto, the head of ChildLine. “Children are communicating in a way we have never seen before – all the time and instantly,” she says. “Personally, I think this kind of relentless exposure is the biggest challenge we have ever faced.”

Minto notes that while peer pressure and bullying have been around for a long time, the ability to be contacted at all times is new. The cloak of anonymity can lead children to make comments they would shy away from in “real” life, she says. “The pressure on children is immense and very worrying – there is no break for these young people, it is quite relentless. Children who are being bullied tell us there is no point in turning off their phone, because the messages will just be there waiting for them.”

A recent survey carried out by youth charities ChildLine, Selfharm.co.uk,YouthNet and YoungMinds revealed that 61% of the 4,000 young people who responded said they self harmed because they felt alone, while 25% cited bullying. Almost 40% said they had never spoken to anyone in the “real world” about it.

Rachel Welch, director of Selfharm.co.uk, which supports young people affected by self-harm, says there is a huge gap between what adults see of the online world and their children’s experience. “So many young people are drifting into a world where they are completely disconnected,” she says.

But how dangerous are self-harm sites? Do they simply show teenage angst and creative expression, or highlight a worrying deterioration of teenage mental health?

Mary Hassell, the coroner presiding over the inquest of Tallulah Wilson, was concerned enough to write to Jeremy Hunt, the health secretary, to warn him of a risk of future deaths without a greater understanding of children’s online worlds. Although Tallulah was treated by healthcare professionals, they didn’t have “a good enough understanding of the evolving way that the internet is used by young people, most particularly in terms of the online life that is quite separate from the rest of life”, she wrote.

A study into possible links between suicide and the internet has just been commissioned by the Department of Health and will report in two and a half years: a department spokeswoman said children’s mental health was a priority for the government and pointed to the introduction of “family-friendly filters” and internet safety into the national curriculum.

But for Sarah Brennan, chief executive of the youth mental health charity Young Minds, the real issue is ignorance of the scale of the problem, or even denial that the problem exists. The current NHS commissioning of youth mental health services is based on data collected in 2004 – the year Facebook launched.

“It is shocking that the government is allowing NHS commissioners to plan services based on out of date and inaccurate data,” Brennan says, adding that a Young Minds freedom of information request recently revealed that 34 out of 51 local authorities in England have reduced the budget for their children and adolescent mental health services since 2010, while a Community Care/BBC investigation this week showed that a growing number of seriously ill children are being admitted to adult psychiatric wards or sent hundreds of miles from home for hospital care.

“We are sitting on a ticking time bomb here,” says Brennan. “At the same time that we are seeing an increase in need, youth mental health services are being cut. There is an explosion of bullying online and young people struggling to cope with mental health issues, anxiety, eating disorders. If we don’t do something about it we could have a lost generation.”

What can be done? Since Tallulah Wilson’s suicide, Tumblr has introduced a warning that pops up when users search for terms related to self-harm, directing them towards sites offering support and calling on users to report blogs with “inappropriate content” so they can be taken down. A Tumblr spokeswoman said the site was “deeply committed to protecting our users’ freedom of expression”, but that it draws lines “around a few categories of content we consider damaging to our community, including blogs that encourage self-harm”.

And while there have been calls to shut down certain sites, such as Ask.fm – which allows users to ask anonymous questions and has been linked to teen suicides – teenagers and professionals spoken to by the Guardian agreed that simply banning sites or “dangerous” search terms was futile. Regulation can also backfire – recent efforts to impose opt-out “objectionable content filters”, backed by the prime minister, have resulted in sites such as ChildLine and Refuge also being blocked.

“We cannot put our head in the sand, simply blame these sites or hope to regulate our way out of this,” says Minto. “We are playing catch-up, but we need to take responsibility. You wouldn’t let your child cross the road without talking to them about road safety and the same goes for the risks of the internet – if we don’t tackle this it’s like opening the door and letting them walk through this cyberworld completely unequipped.”

Welch at Selfharm.co.uk agrees: “Calling for any type of ban is just missing the point. What we have to do is make sure our young people are emotionally resilient, emotionally aware and they know where to go to get help if they need it.”

Others say that while parts of the internet can be dangerous for vulnerable children, it can also provide the means to keep others safe and let them talk about their problems. As many young people contact ChildLine online as call its helpline. Online friends can be a force for good.

Samantha, a 17-year-old who started self-harming when she was 14, says her Tumblr site helped her recover from depression. “I felt like I belonged somewhere, they understood me in a way I felt I had never been understood before,” she says. At one point, she was off school with depression and spent all day online, answering 10-15 messages from other troubled teenagers every day. Now she “has a life” again and is online less frequently. “I’ve been told that I’ve saved lives and it made me feel good about myself that I was helping other people,” she says. “It’s really odd – but it works for me.”

Frankie, who is still working towards recovery, has mixed emotions. While she recognises that some blogs might encourage self-harmers, or make them feel worse, she still believes they can help. “I think for [people] like myself it can be reassuring just to know there are others out there that do it too [but] what scares me is thinking how many there are, how they are all posting it online, are they all cries for help? If that many people are crying for help then something needs to be done, and fast.”

*Names of young people have been changed. If you face any of the issues in this piece, you can call ChildLine on 0800 1111

Young people are sexting – but that doesn’t mean they necessarily want to be, says research

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relationships, sexting, young people

Young people are sexting – but that doesn’t mean they necessarily want to be, says research

With the rise of smartphones and Snapchat, sexting is in vogue – but a new study has found that many young people engage in the practice without really wanting to.

More than half (52.3 per cent) of young adults have engaged in “ unwanted but consensual sexting with a committed partner”, according to research to be published in February in the journal Computers in Human Behaviour.

Most did so for flirtation, foreplay, to fulfil a partner’s needs, or for intimacy, but women were more likely to consent to unwanted sexting because of anxieties about their relationships.

The research, which was carried out by scientists at Indiana University-Purdue University Indianapolis (IUPUI), polled 155 undergraduates in committed relationships on their sexting habits.

Fifty-five per cent of the female respondents said they had previously engaged in unwanted sexting, while 48 per cent of men had done the same.

The results show similarities between sexual behaviour online and off: in both cases, couples will willingly go along with sex, even when they do not feel like it, from reasons ranging from satisfying their partner to avoiding an argument.

But while women are often considered to engage in unwanted sex more than men, the research shows only a small difference in the number of men and women partaking in unwanted sexting.

The authors of the article argued “gender-role expectations” could be to blame. Men might be more likely to agree to undesired sexting because doing so is “relatively easy and does not require them to invest more into the relationship,” while women might be discouraged from virtual sex because it fails to help them attain their relationship “goals”.

The survey also showed that people who were anxious about their relationships were more likely to send begrudging sexts, in a bid to alleviate fears about alienation or abandonment by their partners.

Cancer’s lost generation: the teens and young adults ‘forgotten in the middle’

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diagnosis, misdiagnosis, teenagers, Young adults, young people

Cancer’s lost generation: the teens and young adults ‘forgotten in the middle’

After six months of misdiagnosis, Stephen was eventually told he had bowel cancer. He was 15. A straight-A student, he had always wanted to be a doctor. Now 18, he says: “I’ve lost faith in the healthcare system.” He visited his GP numerous times with “crippling symptoms” and went to A&E on five occasions. “I have a strong family history ofbowel cancer. At one point, we asked the doctor if I might have cancer and demanded further scans. He said: ‘No, definitely not, you’re too young.'”

Over the past three decades, cancer survival rates have increased dramatically. But for teenagers and those in their 20s, the outlook is less promising – several reports have shown that improvements in outcomes for them do not match those among children and older adults.

To investigate this, the National Institute for Health Research has launched Brightlight, a cohort study that hopes to become the largest ever of young cancer patients (aged 13-24). It intends to recruit more than 2,000 people by next April. In earlier studies, two of its leaders, Professor Jeremy Whelan, a specialist in teenage oncology atUniversity College London Hospital, and Dr Lorna Fern of the National Cancer Research Institute, found that one of the critical factors for the “survival deficit” is delayed or mis-diagnosis. Invariably, this leads to a poorer prognosis as the more advanced the cancer is, the harder it is to treat.

According to a study published in the BMJ in October this year, those aged 16 to 25 are twice as likely as older adults to have three or more GP consultations before being referred to a specialist and a 2010 survey found more than a quarter of young cancer patients had visited their GP at least four times, many presenting with multiple “alert”symptoms (lumps, swellings or persistent unexplained pain) before their eventual referral. More than a third of participants at this year’s Teenage Cancer Trust (TCT) conference (the aptly named Find Your Sense of Tumour) were only diagnosed on emergency. Among many young patients there is overwhelming resentment of GPs; a sense that they were not taken seriously, their symptoms dismissed as adolescent fatigue, stress, or persistent hangovers.

It is true that cancer is rare among young people. But it is also the leading medical cause of non-accidental death among them – and the TCT says that in the past 30 years, cancer among teens and young adults has risen by 50%; for the first time, teenage cancer cases outnumber those of children. Young people are also known to contract the most aggressive forms, exacerbated by their growth spurts. Failure to detect the warning signs at an early stage can have devastating consequences, as Stephen’s case shows; his cancer was recently diagnosed as incurable. Raising awareness, he says, is essential to dispel the myth that young people are immune – a situation not helped by NHS campaigns such as Be Clear on Cancer, which feature only older faces.

Greater awareness is also needed to enable GPs to spot the “alarm-bell” symptoms. Since younger patients tend to develop the rarer forms of cancer – leukaemias, lymphomas, sarcomas, germ-cell tumours and cancers of the central nervous system – there is an urgent need for more research to group the specific symptoms of these malignancies.

At the moment, teens and young adults are also seriously under-represented in clinical trials. In a 2008 study, Whelan and Fern found almost half of patients aged 10-14 participated in a trial, but this fell to 25.2% for 15 to 19-year-olds, and just 13.1% for those aged 20-24. For too long, they argue, clinical and research communities have failed to recognise teens and young adults as a distinct category with unique biologies, and they have been left “forgotten in the middle”.

It is the same story when it comes to hospital care; teens and young adults have been identified as a “lost tribe”, caught between paediatric services and those designed for older patients. The National Cancer Reform Strategy (2007) estimated that 70% were not treated in age-appropriate settings; many were left on children’s wards, with the disturbance of crying babies, or isolated in bays with elderly patients and surrounded by constant bereavement.

Those lucky enough to be treated alongside their peers at a young-person unit describe the experience as a godsend. “I was a total mess before I found Teenage Cancer Trust,” says Jasmine Singh, 22, who is recovering from Hodgkin’s lymphoma. She was transferred to a TCT unit with specialist young-person cancer nurses and counsellors, as well as a team of support workers offering education and career advice – a lifeline for young sufferers who fall behind with their studies or training.

In 2005, government directives recommended that all 13 to 24-year-old cancer patients be treated in such units – but at the moment there are only 27 in the UK, and only around half of all young patients are treated in one. The same recommendations stressed the importance of “age-appropriate care”, but there is no real consensus over what this means. The Brightlight study sets out to provide some answers. By interviewing young adults over a five-year period, it aims to gain a clearer insight into the type of care that benefits them the most.

One of the study’s pioneers was Stephen himself, in his capacity as a young adviser at the National Cancer Research Institute. “I don’t know how long I have left because I haven’t asked,” he says. He refuses to waste a moment on self-pity – in between chemotherapy treatments, he is too busy fundraising for TCT, determined to improve the outlook for other young people with cancer.

Old enough to know better: how teenagers cope with a parent’s cancer

Tags

adolescents, Cancer, Children, communication, family, information, parents, responsibility, teenagers, young people

Old enough to know better: how teenagers cope with a parent’s cancer

My daughter Maya is in the family room watching TV. I’m heading out to buy ginger sweets for my wife, Marsha, who’s upstairs in bed, feeling queasy after her latest round of chemotherapy.

“Going to get something for Mum; be right back,” I call to my 15-year-old.

“How is she doing?” asks Maya.

In my head, I think: “Why don’t you ask her yourself since she is just one flight of stairs away!” But I bite my tongue. I don’t want to add to the tension that cancer has already brought to our home.

Looking back, I realise that Maya wasn’t the only family member to avoid direct communication during the seemingly endless months of treatment for Marsha’s breast cancer. Consumed with all things cancer, my wife and I never asked her and her younger sister, Daniela, who was 13 at the time: “How are you doing?”

Many families find themselves in a similar situation: parent with cancer, teens in the house, not a lot of cross-generational conversation. Tens of thousands of children live with a parent who is a cancer survivor. Roughly a third of those children are 13 to 17 years old. While parents pay a lot of attention to the needs of younger kids, they may figure, as we did, that teens are old enough to cope.

“Adolescents are an unheard group,” says Shara Sosa, an oncology counsellor. Unfortunately, the nature of adolescence fights against openness of any kind, never mind the cancer in the family.

“With their kids locked behind a mask of teen indifference, parents are often intimidated and don’t know how to talk to them,” Ms Sosa says.

Teenagers are pulling away from the family, forging their own identity. The news that a parent has cancer yanks the adolescent back into the fold – exactly where they don’t want to be.

The reaction of a teen to a parent’s illness varies widely. Some respond with a disappearing act: after-school activities, shopping trips, sleepovers, you name it, they’ll do it to avoid the uncertain environment at home. It doesn’t mean they don’t love and care about the parent with cancer – it’s just their way of dealing with it all, says Maureen Davey, a family therapy Professor at the Drexel University College of Nursing and Health Professions, in Philadelphia.

Does that mean these kids are likely to turn to risky behaviour? Mental-health experts say that there are no data to quantify this and emphasise that most of the teens they work with do not act out. Yet typical teen temptations are always present.

Of the 100-plus teens who my daughter Maya and I interviewed for a book we wrote about teens and parental cancer, around 10 per cent confessed that they’d turned to drinking, drugs or vandalism as coping mechanisms.

Elissa Bantug, who was 12 when her mother was diagnosed with breast cancer 21 years ago, felt as if her mother had abandoned her. She drank, hooked up with an older boyfriend and forged her mother’s name 36 times on notes to get out of school. When the school asked her mother to come in for a conference, she felt too exhausted from her cancer treatments to turn up.

It’s impossible to say if Elissa would have acted out if her mother had been well. Still, looking back as an adult, Elissa says: “I felt like no one really talked to me.”

And she had lots of questions: would her mother be OK? What does it mean to be a cancer survivor? How would their family life change in the short run and the long run? Her rebellion, she says, was sparked by a lack of information.

Others respond by defying their developmental stage, assuming responsibilities that normally fall to the parents. Out of sync with their peers, these kids sometimes talk about their real age and their “cancer age”.

“I’m 16, and I have to act like I’m 40,” a teenager named Lyndsey told me. While her mother is in treatment for breast cancer, she says, “I have to cook, clean, make sure my mum eats, my brothers are fed.”

A “parentified” teen will inevitably feel frustrated. Teens may be “angry they have to take over everything and nobody appreciates that they’re doing so much more than they used to,” says psychiatrist Karen Weihs, medical director for supportive care at the University of Arizona Cancer Center in Tucson.

Stacy Hoover, a single mother, learned she had breast cancer when her daughters were 13 years old, and 18 months. She leaned on the older daughter, Megan, which took a toll. “Sometimes I wanted to go over to a friend’s house, but I didn’t want to leave my mum with the baby,” Megan recalls. When chemo made her mother irritable, Megan says: “It was hard not to yell back.”

No matter how the teenager responds, the parents can help shape the child’s frame of mind. That means sharing information, regardless of whether the news is good or bad.

Indeed, several studies establish the value of honest communication above all. Medical psychologist Stacey Donofrio looked at nearly 300 adolescents in the Netherlands who were coping with a parent’s cancer. She found that “the intensity of the parent’s treatment” for illness was not as important in influencing adolescent reactions as the way parents talked to the kids about it.

“Adolescents may feel especially uncertain if they feel their parents are not being entirely open,” she said.

Such an information gap elevated the tensions for Jackie Shmauch, a teenager whose father had leukaemia. One night, the 14-year-old fled her home in tears after eavesdropping on a call from her father’s oncologist. Jackie thought her father’s leukaemia was in remission, but she overheard a discussion of a bone-marrow transplant. After her parents found her at a friend’s house, they explained that the transplant was a preventive measure, not a sign that the cancer was back. That’s when Jackie delivered her ultimatum: “If there is information you have and you think you shouldn’t tell Jackie, that’s what I want you to tell me.”

Yet not every teen is like Jackie.

“If your child says, ‘Talking about this with you is not helpful to me’, it’s important to respect that,” says child psychiatrist Paula Rauch, who directs the Marjorie E Korff PACT Program (Parenting at a Challenging Time) at Massachusetts General Hospital in Boston.

It is critical for parents to remember that, cancer or no cancer, they still need to keep an eye on their teenagers – no easy task, especially when one of the parents is ill. The key, Ms Sosa points out, is listening closely even though “your head is in so many different places” because of the cancer diagnosis. That means asking follow-up questions, even challenging your teenager at times. If teens know you’re truly paying attention, she says, “they’re going to tell you all sorts of things”.

Some teenagers may just need a break from all the care-giving – perhaps by having other family members or friends shoulder the young person’s chores from time to time.

“Just to be 12 again, that was really quite a blessing,” recalls Bailee Richardson, now 19, who cared for her two younger sisters while her mother was being treated for breast cancer and her stepfather was working out of town.

A decade after my wife’s diagnosis, Marsha is in good health, but she and I are just beginning to understand how the experience affected our daughters. Maya tells me how uneasy she was with her mother’s bald head, courtesy of chemo, and that she found relief from the free-floating cancer anxiety that infiltrated our home by turning to friends, even if they didn’t quite understand what she was going through. And she’s sorry she didn’t help out more.

I, too, was sorry she didn’t step up. But I made the mistake of assuming that Maya and her sister could read my mind. I once exploded when my daughters didn’t rush to my aid as I dragged in bags of groceries after a day of errands.

“Can’t you give me a hand?” I yelled.

Maya calmly said: “We’d be happy to if you’d ask us.”

When the Bully Is a Sibling

Tags

abuse, aggression, anxiety, Bullying, Children, Depression, family, Self-esteem, siblings, young people

When the Bully Is a Sibling

Siblings have been bickering and trading blows since the time of Cain and Abel. But the torment and fighting that is often shrugged off as normal sibling rivalry may not always be so benign.

New research suggests that even when there are no physical scars, aggression between siblings can inflict psychological wounds as damaging as the anguish caused by bullies at school or on the playground. The findings offer an unusual look at an area of family life that has rarely been studied, in part because infighting among brothers and sisters is widely considered a harmless rite of passage.

But ordinary skirmishes over the remote or joystick are one thing, experts say, and chronic physical and verbal abuse, particularly when it is directed at one sibling, is another. The new study, which involved thousands of children and adolescents around the country, found that those who were attacked, threatened or intimidated by a sibling had increased levels of depression, anger and anxiety.

Corinna Jenkins Tucker, the lead author of the study, which was published in the journal Pediatrics, said that behaviors among siblings that cross the line into abuse deserve more recognition.

“Historically, the general thinking has been that it’s not a big deal, and sometimes it’s even viewed as being a good thing,” said Dr. Tucker, an associate professor of family studies at the University of New Hampshire. “There appears to be different norms of acceptability. Peer aggression is unacceptable, but it’s not the same for siblings.”

Dr. Tucker said that the growing number of programs and public service announcements aimed at stopping bullying and violence in schools and other settings should include a focus on sibling relationships as well.

“The aggression among siblings should be taken just as seriously as that among peers,” she said.

While normal rivalries with siblings can encourage healthy competition, the line between healthy relations and abuse is crossed when one child is consistently the victim of another and the aggression is intended to cause harm and humiliation, said John V. Caffaro, a clinical psychologist and the author of “Sibling Abuse Trauma.” Parents who fail to intervene, play favorites or give their children labels that sow divisions — like “the smart one” and “the athlete” — can inadvertently encourage conflict.

Nationwide, sibling violence is by far the most common form of family violence, occurring four to five times as frequently as spousal or parental child abuse, Dr. Caffaro said. According to some studies, nearly half of all children have been punched, kicked or bitten by a sibling, and roughly 15 percent have been repeatedly attacked. But even the most severe incidents are underreported because families are loath to acknowledge them, dismissing slaps and punches as horseplay and bullying as boys just being boys, he said.

“Our society tends to minimize child-on-child violence in general,” he added. “We have these ideas that if you’re hurt by a child it’s less injurious than if you’re hurt by an adult, but the data don’t support that.”

In the new report, Dr. Tucker and her colleagues studied 3,600 children using data from the National Survey of Children’s Exposure to Violence, which collects information on children and teenagers under 17. Previous studies of sibling violence, which are few in number, have typically been small or narrowly focused on specific forms of aggression.

But the new research, conducted through interviews with children and their parents, measured the impact of a broad range of violence. It looked at physical assaults with and without weapons and the destruction or stealing of property, as well as threats, name-calling and other forms of psychological intimidation.

The researchers also measured the same types of behaviors perpetrated by peers outside the home and accounted for them in their findings in order to tease apart the specific toll of sibling violence.

Over all, a third of the children in the study reported being victimized by a brother or sister in the previous year, and their scores were higher on measures of anxiety, depression and anger.

Catherine Bradshaw, an expert on bullying and the deputy director of the Center for the Prevention of Youth Violence at Johns Hopkins University, said the study was impressive in its scope and scale, and noted that it showed that all types of sibling aggression, from mild to severe, were associated with worse mental health.

“Parents at times might be thinking that their kids can fight it out or that a little bit of victimization might not be so bad,” she said. “But these findings suggest that the threshold is pretty low. It’s not just the rough stuff you have to keep an eye out for.”

Dr. Caffaro said that the effects of sibling abuse often continue into adulthood. Over the years he has treated patients who struggled with emotional issues and sabotaged themselves in their careers because of repeated humiliation they experienced at the hands of a brother or sister.

“It can erode their sense of identity and their self-esteem,” he said.

Cyber bullying: ‘He told me he was a footballer. I wasn’t to know I was a victim

Tags

Bullying, Children, Cyberbullying, Depression, mental health issues, risks, self-harm, sexual bullying, social networks, suicidal, young people

Cyber bullying: ‘He told me he was a footballer. I wasn’t to know I was a victim

When 15-year-old schoolgirl Lain Lerouge was contacted through Facebook by a professional footballer, she was not star-struck in the least. The player, who starred for a Football League club, was already friends on the social networking website with mutual acquaintances and she assumed that was how he came to first contact her. After their initial internet meeting, she and the 19-year-old player developed a closer relationship, chatting every day via their accounts and even talking regularly on the phone.

Lain, from Birmingham, said: “We just had normal, friendly chats. He would ask: what are you studying? Where are you from?”

Even when her online friend declared his love for her and asked her to send naked pictures of herself, she had no reason to doubt his identity. “I refused but then we’d talk on the phone. There was no question that it was a guy from London. His Facebook was flooded with girls, but I just thought he’s a footballer that’s totally normal. I know that I never met him and didn’t really know him, but if you chat to someone a lot you sort of feel like you know them. He seemed so normal,” she said.

The suspicion that she had been deceived came only when she received his telephone call and the number came up with Birmingham dialling code rather than a London one. This rang immediate alarm bells, and after some detective work Lain eventually traced the Facebook account to an older girl who went to the same school as she did.

It quickly emerged the student, who was in the year above, had set up a fake profile with pictures she had secretly downloaded from the account of a very real professional player. For her part, Lain said she simply felt embarrassed when she discovered she had been duped. “I never did get to the bottom of what motivated the hoax, but I was just so thankful that it wasn’t an old man.”

Lain’s bizarre experience is by no means an isolated case. Campaigners warn that growing numbers of children and teenagers are being bullied or even lured into sexual exchanges through bogus online profiles. Some young people are becoming depressed, even suicidal after falling victim, according to a survey by the charity Beatbullying.

Richard Piggin, deputy chief executive of Beatbullying, said: “Young people have told us about this alarming trend of fake profiles being used on social networking platforms to cyber bully and to engage in sexual bullying. The psychological impact of this form of bullying can be hugely distressing for many young people, with tragic and terrible consequences.” In a survey carried out by the anti-bullying charity, it discovered that nearly one-third of the 500 young people questioned say they have had a fake profile made about them on a social networking site. A further 65 per cent said they knew someone else who had been impersonated through a phoney account.

Beatbullying said the poll also showed that high numbers of the under-18s questioned had developed serious mental health issues after being targeted. Nearly one in 10 said they became depressed; 4 per cent developed an eating disorder; 7 per cent had suicidal feelings and the same number self-harmed. Another 13 per cent reported feeling afraid.

The extent of fake profiles on Facebook was revealed in the firm’s own financial records last August, which showed the site had 83 million fake profiles. But a Facebook spokesman stressed that the majority of these accounts had no malicious intent and were pages set up for businesses, pets or small children. He added that unlike with many other social networking sites, fake profiles can be reported directly to Facebook, which will then remove them. The spokesman stressed that the company acted swiftly on such reports. “Everyone on Facebook has access to simple tools to block and report people who make them uncomfortable.”

Mr Piggin added: “What social networking sites like Facebook need to do is work with organisations like us. They’re experts in technology, but they’re not experts in bullying and sexual bullying.”

Tony Neate, chief executive of the partly government-funded Get Safe Online, said: “Social networks are a great place for young people to talk to their friends, share photographs and play games – but children and parents must be educated on the risks that are around.”