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Former patients play a key role in self – injury Gothenburg Opinion


The clinic targets people with serious self-harm behaviors.

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"The closest definition to our patients is that they have life-threatening problems," says Nina Pedersen, head of department at Eastern Hospital in Gothenburg.

A working group of 40 people, including psychologists, nutritionists and physiotherapists, lead the treatment. There are also so-called peer supporters, a personal resource for their own experiences. These are certified support persons with their own experience of mental illness.

“I cut myself, burned myself, took drugs, drank too much, went straight out of the road and thought it would be a car, so do it. I was exposed to a lot of dangerous situations, "says Tess Johansson, one of the department's two supporters.

Patient conditions

The treatment lasts for three months, with the possibility of extension to six months. Since its inception on Monday, three of the ten seats have been filled.

– We have a very structured and intensive treatment program. All staff will work as coaches and will have several employees on site throughout the day, says Nina Pedersen.

The initiative comes from the Västra Götaland region and Sahlgrenska University Hospital, where Eastern Hospital is included. The department operates on the basis of a method called Dialectical Behavioral Therapy (DBT). All people's behavior is supposed to be a function for themselves, says Nina Pedersen.

“We can probably all feel that under extreme pressure or pain, we are doing what it takes to rid ourselves of evil. And self-harming behavior works, things happen physically in the body. But then there are obviously negative consequences, she says.

Most women

According to the National Health Council, women are over-represented among those seeking self-destructive care. Over 4,000 women sought care in 2017 and only half of the men were. The statistics apply to closed care and do not include those who have only contacted, for example, a health center. Many associate self-harm behaviors with young girls, but this is a problem that can affect everyone, says Nina Pedersen.

– This is a complex problem associated with many medical conditions. People with emotional instability, eating disorders, post-traumatic stress syndrome, depression, neuropsychiatric problems and people with psychoses may have self-harming behaviors, she says.

Bipolar and anorexia

Tess Johansson's problems began at school when she was bullied and developed bulimia, and later anorexia. It went so far as to get emergency food at 14 years old.

– In the event of such a severe eating disorder, you get a tremendous increase in anxiety from eating. I used to slam my head against the wall, but then I saw others manage to cut themselves, she says.

Later, she also learned that she had bipolar disorder, something she managed to stabilize today and learned to live with. As a patient, care was not always the best.

“They have told me so often that I will regret having ugly hands and scars for life. They thought it would stop me, but I was just ashamed and it caused more anxiety and more injuries.

TT: What do you think your patients will notice about the difference?

"It will probably come as a little shock that we will be so kind." Many people are used to listening, just as I have received that they are a hopeless case.

Elias Arvidsson / TT

As a former patient, Tess Johansson is well aware of the pitfalls of care. Today, she works in Sweden's first specialized department for self-harm behavior. Photo: Björn Larsson Rosvall / TT

Sweden's first specialized clinic for self-harming people opens at Östra Sjukhuset in Gothenburg. Tess Johansson, Partner Support, and Nina Pedersen, Head of Unit. Photo: Bjorn Larson Roswal / TT

Self-harming behavior typically debuts in younger teens and diminishes in adulthood.

Behavior also occurs in children under 12 years of age.

Young people who are injured are at increased risk of mental illness, prolonged self-harm and abuse behavior.

In a Swedish study, in which high school and high school youth had to answer questions from a checklist of examples of different self-harm behaviors, 35-42 percent said they intentionally injured themselves at least once. (Examples include both more lenient and more serious self-harming behaviors).

Internationally, the incidence of self-harm (no suicide intent) in young people is estimated at 13-28 percent.

Several studies among young people show that more girls than boys have self-harm, but over the years boys' problems have turned out to be greater than expected.

There is some support for boys and girls who hurt themselves in different ways. For example, girls are overrepresented in cutting and taking pills, while boys, for example, are more often intentionally burned or beaten to injure themselves.

There is also some evidence that girls are more commonly reported to injure their arms and legs, while boys are more likely to damage their breasts, face and genitals.

Source: National Self-Injury Project

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