There is a big difference between self-harm and suicide, according to psychology experts. (Credit: Matt Grover/Flickr Creative Commons)
Parents of students at Normandie Avenue Elementary school were shaken last week upon learning of an incident in which more than a dozen fifth-graders began cutting themselves during class in the presence of a substitute teacher.
On Thursday the L.A. Unified School District confirmed reports that the students took the blades out of their pencil sharpeners and began slicing their arms. A few of the children were so badly hurt they needed to be treated at the hospital.
As of Friday, one was still there receiving care.
Fifth-grader Joshua Mendoza told CBS that the incident likely had something to do with bullying, and another told the media outlet that it "just started randomly."
But Pia Escudero, LAUSD's director of School Mental Health, Crisis Counseling and Intervention Services, called the choice to interview students "unfortunate."
"I don't think that student even knew about the incident," said Escudero, a licensed clinical social worker. "I think that children are very misinformed and don't have the facts."
In its report, CBS suggested that the incident happened as part of a "suicide pact" with its headline: "Did A Dozen Elementary School Students Sign a Suicide Pact?" Escudero said there was no evidence they had.
"It is my understanding that this is not a suicide pact," she said. "It is my understanding that one child may be of need and got support from the department of mental health."
Escudero explained that that one student began cutting himself, and the other 11 students, perhaps viewing it as a "rite of togetherness" or "bonding with peers," she said, began to follow suit.
"Most of the children involved did not exhibit suicidal ideation or self-injurious behavior," she said. She elaborated that groups of students will sometimes do something to get attention from each other or feel accepted and, in the process, "demonstrate behaviors that are not healthy."
Ian Mathis, a psychologist and fellow with the Mental Illness research, Education and Clinical Center at the West Los Angeles VA Hospital, said there's a major difference between self-harm and suicidal behavior.
"The biggest difference between the two from my perspective is one of intent," said Mathis. "With a suicidal act, the intent is obviously to end the suffering person's life." Mathis added that suicidal acts usually come from "a place of profound hopelessness, deep depression and a feeling of worthlessness." Self-harm, however, is different.
"With self-harm, typically, what you find is that their action is based on a sense of deep internal pain or overwhelming anxiety," said Mathis. "It also can be indicative of a feeling of profound numbness. You'll often hear that self-harm is associated with tension or anxiety release, or allowing a person to feel anything." Self-harm, said Mathis, is a way of providing a "more direct connection with the world around" a person, usually because he or she does not feel that connection.
"The underlying mindset tends to be quite different between someone who is suicidal and someone engaged in self-harm behavior," he said.
Escudero emphasized that the incident was "complex" and said these kinds of things don't just happen in South L.A.
"Self-injurious behavior exists in all corners of L.A. County," she said. "It's not related to socioeconomic background but it actually is significant that children are not managing overwhelming feelings and are doing something that can destruct the body and it's not healthy behavior. … I don't think it's specific to South Central L.A.."
She added that the behavior that took place at Normandie Avenue Elementary was abnormal. "But it doesn't mean that [LAUSD doesn't] see this frequently," she said.
"We are not aware that there is an intent to commit suicide from all the children that were involved in this incident," Escudero said.
As for making the jump from self-harm to suicide, Mathis said in all likelihood a lack of knowledge was behind that.
"I think making the jump from observing a self-injurious behavior to inferring suicidality is most likely indicative of just not having a good understanding of the mindset behind the two types of behavior," he said.
Photo by Matt Grover via Flickr Creative Commons.
3/19/12, 2:52 p.m.
I agree with both of the professionals. I have engaged, in the past, in self-injurious acts, but in my case it was due to finding myself totally overwhelmed by emotions I absolutely did not know how to cope with at all. It is like that old "Doc, my toe hurts" so the doctor hits the patient with a hammer, and the patient exclaims, "Ow! Why'd ya do that?," and the doc answers, "well, now you are not thinking about your toe." It was a way for me to get out of a drowning pool of emotions. Iwould distract myself with intense physical pain, to get some releif from the worse, overwhelming mental state.
As far as suicide, I am Bipolar - the more intense kind, and have experienced not only a lot of mania, but also mixed states. I have read that those states are more likely to result in a suicide attempt than a depression. My own experience tracks that assertion - I have had serveral suicide attempts, rarely in a depression, but in the manic and the mixed states - especially if substances are involved.
I strongly encourage parents to not hesitate to take their kids to a mental health clinic if there are sudden, unusual changes in your child's moods, activity level, sociability, or drop in grades, and if the isolate. The NIMH has a lot of information about the signs and symptoms of behavioral health issues. Beleive me - it is so much better to catch it early. I got directed to a public mental health just by a chance encounter with a stranger who had the same diagnosis as I, so she knew the symptoms. I was like 37 or 38, and a rip roaring drunk, trying to escape the way I felt, the way I thought, etc. Don't let your kid wait so long in pain if you suspect something.