IT’S 2AM on a Monday night in November.
Kelsey Gordon, a 20-year old with bleached blonde hair who wants to become a human rights lawyer, is in a hospital bed trying not to look as two doctors treat the wounds she has made in her legs.
With every staple she makes a small yelp that echoes through the unusually quiet emergency department.
Another doctor doing his rounds stops to stare.
“Why are you flinching?” he scoffs.
“I thought you liked pain.”
Kelsey bursts into tears. She’s not a masochist. She doesn’t like pain.
Yet from the age of 13 when something went wrong in her life, from a bad grade to a fight with a friend, she would self-harm.
It started with little scratches – faint lines that could be mistaken for a bike fall or a bump into a door.
But, it quickly escalated to using razors she specifically bought to inflict deep cuts.
Since 2011 she has been hospitalised more than 20 times.
Now 21, Kelsey is part of a generation increasingly turning to self-harm to express their feelings.
Last year, 835 teenagers aged 17 and under were admitted into Perth metropolitan emergency departments for self-inflicted injuries.
And experts warn that’s just the tip of the iceberg.
“Very few incidents of self-harm will actually result in hospitalisation and those that do won’t necessarily be recorded as self-harm,” Jono Nicholas, chief executive of youth support service ReachOut, said.
“There is very little comprehensive research that has been compiled on self-harm in Australia.”
The crisis has become so bad Mental Health Minister Helen Morton recently announced a new specialised clinic for WA teenagers would be opened in Bentley.
Acute medical help is one thing, but the victims say they need understanding about why they hurt themselves more than anything .
Kelsey, a law student at the University of Western Australia, said self-harm victims were misunderstood within the WA mental health system and in schools.
She self-harmed throughout high school and said teachers at her Rockingham school were aware of her problems, but did very little to help.
“There was one visit to a councillor when I was in year 8 with no follow-up to ask how I was,” she said.
A high achiever, Kelsey said her outstanding academic performance meant the severity of her problems were not taken seriously when she was taken to a GP.
“I think if it had been addressed properly then it wouldn’t have spiralled into an addiction in my adult life,” she said.
Cristee Parker, 23, said her addiction to self-harm was as powerful as heroin.
“Once you’ve cut yourself once, it’s like a first high you keep chasing,” Cristee, who has self-harmed since she was 12, said.
“As the years have gone by, I kept cutting deeper and deeper, trying to get that first feeling back. But it never really returns.
“I go to cutting the same way a child would go to a blanket. It’s constantly at the forefront of my mind most of the day and the smallest little things can trigger the thoughts.”
After more than 10 years of self-harm Cristee’s scars, which she calls her battle wounds, are so visible that when she walks down a busy street she is followed by whispers and stares.
“It can get quite embarrassing,” she said.
“People will stop me on the street to ask me what happened to my arms. Just a couple of months ago I was on a bus and a couple of teenage boys saw my scars and told me to go kill myself.”
Like Kelsey, Cristee said she encountered a severe lack of support at school.
At 14 her Kalamunda school suspended her for self-harming on school property.
“I was in a really fragile place and it all gets a bit hazy,” she said.
“But I remember feeling like they thought I was too much hassle to deal with and I was bad for their reputation.”
After being suspended, Cristee changed schools.
She said there was a similar lack of empathy within hospitals, particularly emergency departments.
“Doctors roll their eyes at me, like, ‘Oh I have to stich you up again’, and it makes me feel like a lower part of the human race, as if because I’ve done it to myself I’m not as deserving of help,” she said.
“No one really chooses to self-harm.
“If I could just stop I would have done that 10 years ago. I never wanted it to take over my life like this.”
Cristee, who used to think of razors she hid under her bed as a “goodie bag”, said it was important to distinguish self-harm from suicide.
“It’s mostly about escape… not a death wish,” she said.
“I think it’s worse for my family, though. My sister has come home before to an empty house with a trail of blood in every room and me gone. I can’t think about what it must be like for my mum. To have given birth to someone and loved them so much, only to see them destroying themselves like that.”
Psychologist Sherry-Lee Smith said one of the biggest misconceptions among health workers is that young people who self-harm are just attention seeking.
“This is rarely the case. Most young people who self-harm go to great lengths to hide the fact their scars,” she said. “These young people are experiencing genuine psychological distress.”
Ms Smith said some psychologists encouraged self-harmers in the early stages of therapy to try alternative strategies when they felt the urge to hurt themselves, such as placing ice on arms, flicking elastics bands on wrists and using red food colouring or red texture to replicate the image of blood.
Known as distress tolerance skills, Ms Smith said the strategies worked similarly to a nicotine inhaler in replicating the feeling of self-harm while minimising the physical harm to the body.
Mary-Jane Bell, who runs a support group for families of self-harmers in Mirrabooka, said she believed self-harm had risen because of the extra pressures placed on young people.
“It’s a mental illness and has always existed, but now as young people have so many additional pressures from social media and expectations to excel at school, it has become almost mainstream,” Ms Bell said.
Josh Harris said he started with scratching at 12 after intense social pressure. It soon escalated into burning himself with a lighter.
“My father was sent to prison and I was experiencing severe bullying,” he said.
“It started off about controlling my own pain.”
Since 2011, more than 650 males aged 17 and under have been admitted to Perth metro emergency departments after self-harming.
“A lot of males are very self-conscious about it – they don’t like showing weakness,” Josh said. “There was only one occasion where I really cut myself and I felt very conscious that it was considered a feminine thing.
“I tried to find ways to make my self-harm more masculine. I would throw myself against a wall or try and choke myself until I passed out.”
Josh said the judgement he received from others made him feel even more guilty about his habit.
Joanne Lockhart, a counsellor and Josh’s mother, said her biggest advice to other parents dealing with children self-harming was to avoid lashing out.
“Don’t release that initial fear and anger on your child,” Ms Lockhart said. “It can be terrifying, but you need to acknowledge that it is a coping strategy. It might be a very bad coping strategy, but your child is trying to tell you about some other pain in their life.”
Youth Focus clinical services manager Chris Harris said in the past three years he had seen a considerable increase of self-harm among young men.
“Often they use methods such as hitting oneself that leaves injuries that can be mistaken as normal, reckless teenage behaviour,” Mr Harris said.
He believed the same compassion was not afforded young people struggling with self-harm as other mental illnesses. He said the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, considered the bible of mental health diagnosis, was currently reviewing whether self-harm should be treated as a mental illness in its own right.
“Moving forward, we need more research,” he said. “We are doing these young people a disservice if we do not.
Mr Harris said self-harm can trigger a neurological response in the brain, which reduces anxiety. He said this chemical response was part of the reason self-harm became addictive.
Brooke Tyler, 21, said the shame attached to self-harm was worse than the physical pain. She started self-harming at 13, but kept it a secret for nearly two years.
Brooke said she was desperate to shield her past from her little sister, now 13.
“She’s very innocent so I’ve told her my scars are from falling on barbed wire one day,” she said.
“I do worry about her…I hear about 11-year-olds self-harming and I think what are they doing? How do they even know what that is? But then I think back to me and I had no idea what I was doing.”
Brooke, who once smashed a light bulb while being treated at hospital because she was so desperate to cut herself, said only in the past year has she become comfortable revealing her scars publicly.
“I used to go out in long-sleeved tops in the middle of summer,” she said.
“But I realised that the secretiveness was part of my ritual of self-harm and that if I wanted to recover, I needed to accept that the scars are a part of what I’ve been through.”
After missing several years of school due to health issues, Brooke is set to complete year 12 at a Bassendean school.
On the first day Brooke dared to bare her scars at school, she was told by a teacher to cover them up.
She was previously told by a nurse she was “wasting resources”.
“She said they could disturb or trigger other students,” Brooke said.
“Self-harm isn’t contagious. I was really upset. You would never tell a burns victim to cover their scars.”
Mary Rogers, 17, said at her Churchlands school there were at least 20 other students in her year group struggling with self-harm.
“Then I look at the younger years and there are just more and more students,” she said.
Mary said when she first started self-harming she had no idea what she was doing.
“It all starts with one first scratch and that builds and builds to cutting down to arteries,” she said.
“I couldn’t understand what I was doing and I couldn’t explain it to others. The only thing I knew was the release that came with it.”
Mary dreams of being a mental health nurse when she graduates from school so she can help others like her.
“I’m not recovered yet,” she said. “Every day is a struggle. But I see others that are and there is that glimmer of hope there. It might not be today, but one day.”
This article first appeared on ‘Perth Now’ on 14 December 2014.