Case Study – Becky’s story

“My favourite singer is Rihanna, I like shopping and going to the cinema.”

Becky is like any other teenage girl looking for adventure: she enjoys hanging out with friends and having fun. But she doesn’t live at home with her family: she lives in a special home for teenage girls who chronically self-harm.

Becky is 14 years old and lives at Care UK’s Newcombe Lodge in Gloucestershire, a new four-bed intensive care home designed for young adolescent women who require a period of medium to long term residential care and therapy. Newcombe Lodge is part of a collection of facilities known as Althea Park specialist care services that provides specialist residential care to adolescent and adult women with eating disorders or women who are prone to self-harming.

Newcombe Lodge was purpose-built by Care UK in 2009 to provide a half-way house between a social service secure psychiatric setting and Newcombe House, an existing Care UK therapeutic home.

Martin Davies, Care UK’s Operations Lead for Althea Park services said: “For some young women, living in a secure unit is the best option. But there are others who get stuck in the revolving door of social services, going round and round, rather than forwards through the system.

"Generally our clients are people whose treatment has failed everywhere else and our philosophy is to change something that isn’t working. We aim to cure what others see as the incurable and these people are what Althea Park’s services are designed around.”

Self-harm is a combination of disorders such as depression, obsessive compulsive disorder and other mental health issues. Self-harm is an addiction and people suffering from this disorder hurt themselves to replace their psychological pain with physical pain. The typical self-harmer is impulsive, has little or no control over their emotions and has an extremely low self-esteem.

Martin added: “For our residents, accepting help is the biggest challenge. It is only when we look at the world through the eyes of the people we care for that we can begin to understand why they self-harm and why they have not responded to past treatments and settings. Only then can we truly appreciate what obstacles we are asking them to climb.”

The first time Becky self-harmed was by accident. She recalled: “I was feeling really angry and upset and I blamed myself for what was going on at home. I lost control and started throwing things around my room and I cut myself by accident on a broken glass. Instead of feeling pain it felt like my anger and frustration had been released from my body and I felt better. When I cut myself the blood takes away the bad feelings.”

Alison Hudson, Home Manager at Newcombe Lodge, said: “When people think of self-harm, they often think of a person cutting their wrists with a sharp blade. But people who chronically self-harm use anything they find to cause themselves damage, such as using items of clothing as a ligature, swallowing small objects and banging themselves against walls.”

Becky continued to cut herself every day and eventually her parents found out; “My parents were really angry with me and disowned me. I felt like my whole life was a mess, so I took some pills and tried to kill myself.”

Becky started having regular meetings with nurses and psychiatrists and was then put in foster care. She continued to self-harm and was referred to a secure psychiatric unit; “My room was like a prison cell and the building was surrounded by a high fence with prickly metal on top. They tried to stop me from hurting myself but it was all I could think about.”

After some time living in the secure unit, Becky was transferred to a children’s home, which later closed down. Becky was then transferred to Newcombe Lodge.

Although Newcombe Lodge looks and feels like a normal home, everything has been risk assessed and any object that the residents could use to hurt themselves has been removed.

Alison added: “Newcombe Lodge has been specifically designed around the needs of our residents who have usually come from abusive, violent and neglected childhoods and the majority of them self-harm every day. Most of our residents have failed in secure psychiatric units or may have been moved from different foster parents or children’s homes.

We have anti-ligature doors, light fittings, windows and curtains fitted and all sharp objects and cleaning fluids are locked away.”

Care UK’s Althea Park is the only dedicated nurse-led self-injury service in the UK for people who have injuring and complex health needs. The care team encourages the residents to live as independently as possible and to go out in to the local community and start to rebuild a normal life.

Martin added: “For the majority of our residents their disorder has become their identity. We are trying to get them their life back and to encourage them to go out and get life experiences so they can create happy memories for themselves. Secure hospitals cannot do that.

"In secure environments, carers remove anything that the residents can use to hurt themselves. But at Newcombe Lodge, staff provide coping mechanisms to encourage the young woman to realise that they can avoid hurting themselves by controlling their emotions."

Alison explained: “Self-harm might always be with the person, but we teach them to manage their different sets of feelings and thoughts so they can stay safe and healthy whenever possible.”

When a resident is particularly distressed, care staff at Newcombe Lodge bring out an emergency box which contains different objects that the resident can use as a distraction to hurting themselves.

Alison added: “We try to encourage them to stop on their own. The only time we intervene is if it is a medical emergency.
 
"When a resident feels like they need to break something or cause damage we hand them some ice to throw against a wall. If they feel the urge to see blood we give them an orange filled with red dye so they can cut it and see blood-like liquid, and if they feel the urge to scratch their skin, then we give them henna tattoos to put on so they can pick it off as if they are picking a scab off their body.”

Some of the young women who have stayed at Care UK’s specialist self-harm unit have gained a number of real life achievements as well as getting an education and doing vocational courses. These include working in part-time employment or having work experience, attending youth clubs, taking driving lessons, keeping pets, developing community based friendships and generally doing anything that other teenagers might do.

The average length of time someone stays at Newcombe Lodge is 12-18 months. Care UK provides a complete after care package and care workers to support the young people and guide them through their options and stages of independent living.

Alison said: “If the resident is ready to go home, and it is safe for them to do so, they can. However, this is less likely for residents who have come from an abusive home where they have been exploited badly. But if they still need some help they can go into supported living.”

Becky continued: “I think I am getting better as I don’t self-harm every day any more.  I prefer it here to anywhere else as it is calm and it is more chilled out than other places I have been.”

*The name of the resident has been changed to protect her identity.