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RESEARCHER SPOTLIGHT: Mary Kay Nixon

Study of Self-harm Brings National Research Network to Life

Her young patients had her from the start with their wrenching tales of self-harm. Dr. Mary Kay Nixon was gripped by the stories she heard from the "cutters" she was treating, and touched by their willingness to talk about a behaviour they generally hid from the world.

But when Nixon went looking for more insight into why the teenagers in her psychiatric care were hurting themselves, she realized little research had been done on the subject.

That was almost 15 years ago, when Nixon was a staff psychiatrist at the Children's Hospital of Eastern Ontario in Ottawa. Today, she's a Victoria-based academic and clinician who wears a number of hats: consultant psychiatrist for the Saanich Child and Youth Mental Health Service, psychiatrist for the first-episode psychosis clinic for youth at Queen Alexandra Health Centre, clinical assistant professor in the Department of Psychiatry at the University of B.C., and affiliate clinical assistant professor in the Division of Medical Sciences at the University of Victoria.

But her interest in the issue of teenage self-harm has never waned. With more of her own research behind her now, she has some alarming statistics underlining the importance of developing greater understanding into non-suicidal self-harm among young people.

"Why do they start? And why does it become so habitual for some?" asks Nixon of the cutting, scratching and hitting behaviours that characterize this kind of self-harm. "They will often tell me that it's the only thing that makes them feel better or helps them to cope."

Nixon and fellow researchers at UVic and CHEO asked about self-harm behaviours as part of the last two waves of the Healthy Youth Survey, which interviewed more than 660 Greater Victoria youth in 2003, 2005 and again in 2007.

The youth in the 2005 survey were between the ages of 14 and 21. Almost 17 per cent reported engaging in acts of non-suicidal self-harm at some point in their life - a third, repeatedly. Barely half of them had sought help for it.

The youth participating in the study came from a variety of backgrounds: "By far, it's not a homogeneous group," notes Nixon. But there were significant correlations with mental health difficulties. Those reporting mood or regulation of attention problems - depression, impulsivity - were more likely to have self-harmed.

In a previous study of hospitalized youth, Nixon notes: "We saw many addictive features to their repetitive self-harm. That helped us see we had to treat it as such - that you couldn't just expect someone to stop doing it."

Data from the 2005 population-based study is now in hand, and will shed light on the reasons youth engage in self-harm. Meanwhile, Nixon and a network of Canadian researchers are working together to gain insight into the many facets of youth self-harm. More information is available on the Interdisciplinary National Self-Injury in Youth Network Canada website.

Nixon and colleagues from the Capital Region MCFD child and youth mental health services launched self-harm groups in Greater Victoria in the last three years - one for adolescents, and the other for their parents. "We've done five series so far, each of them 10 to 12 weeks," she says. "And I can tell you that there's no shortage of interest."

Successful strategies for dealing with self-harm will require an integrated approach, says Nixon. Educators and clinicians alike will need to know how to respond sensitively to situations. "You have to ask each individual what the reasons are, because they're often different," says Nixon. "And most importantly, you can't be judgmental. You need to have a reasonable expectation of change."

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