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signs to look out for. This could be done in as little as an hour. This hour-long investment will mean staff feel more confident discussing eating disorders and self-harm and may be able to spot potential cases before they develop into something more serious.

      Let staff know how they can offer proactive support to sufferers

      This is especially important when you have known cases of eating disorders or self-harm in school, or where you have a student who has returned from treatment. Staff can often feel very uncomfortable, with little idea of how to help. By sharing really practical ideas and strategies with them, you will help them to realize that they are able to offer an important input and are in a great position to support the student.

      Have a clear policy

      Your school should have clear policies and procedures in place for responding to cases of self-harm and eating disorders. These may be discrete policies or they may form part of another policy, for example, your child protection or safeguarding policy. Wherever this information resides, the key thing is that roles and responsibilities should be made very clear and all staff should know who to refer their concerns on to if they suspect that a child may be suffering from self-harm or an eating disorder. In schools where no one talks about eating disorders or self-harm and there is no clear policy or procedures being implemented, cases will often fall through the cracks until they have reached a critical stage.

      ‘I suspected he was self-harming, all the tell-tale signs were there, but naively I thought that someone else was dealing with it and that it wasn’t my place to become involved. It was weeks and weeks after my first suspicions that he spoke to me about his difficulties and it became clear he was not receiving any support. I felt incredibly guilty about all that time he’d been suffering alone and I’d just stood by and done nothing to help.’

      Routinely talk about mental health and emotional wellbeing concerns

      In meetings where you address behavioural and academic concerns about students, try and introduce the idea of also discussing any mental health or emotional wellbeing concerns you have. By talking about concerns early on and in a forum where there are other members of staff who may be able to help contribute to the whole picture, you put yourself in a good position to pick up cases early and provide the support that’s needed at a point when it is most likely to be accepted and effective.

      ‘It felt a bit weird at first because we were more used to talking about academic performance and bad behaviour, but we soon got used to mentioning kids whose wellbeing was a cause for concern and it turned out to be a great forum for it too. You’d be surprised how often kids who start struggling academically or whose behaviour has deteriorated have an underlying problem with their mental health or wellbeing. If you can get to the bottom of that and help them to address it, their grades and their behaviour seem to follow.’

      As well as enabling you to identify cases, routinely talking about concerns about student wellbeing will make all staff feel more comfortable talking about these issues. It will also raise awareness about the risk factors and warning signs that all staff should be on the lookout for.

      Common misconceptions about self-harm and eating disorders

      There are many widely perpetuated myths about self-harm and eating disorders. Taking time to understand these misconceptions and dispel those myths within the staff and student body can be a key way to address the stigma associated with self-harm and eating disorders as well as other mental health and emotional wellbeing issues.

      You may choose to take a targeted approach to dispelling myths, or simply to ensure that you have the knowledge and information you need to tackle them head on as you hear them at school. Either way, making an effort to correct people’s misconceptions can play a key part in providing a more understanding and accepting climate for those students who are attempting to overcome their own self-harming or eating disorder difficulties.

      Myth: Eating disorders are a result of vanity and are caused by the media

      It is commonly believed that people with anorexia are starving themselves in a pursuit of thinness and beauty and that these behaviours are caused by the Photoshopped images we are all bombarded with daily in magazines, online, on TV, on billboards – everywhere we look.

      It’s true that being surrounded by the ‘thin ideal’ and images of unobtainable beauty can lower our self-esteem and make us strive for perfection and may contribute to the early stages of an eating disorder, but eating disorders are serious mental health issues which go far beyond diet and vanity. With a full-blown eating disorder, the sufferer’s food, weight and shape are used as a coping mechanism – that might mean depriving themselves of food, or it might mean bingeing on food to comfort themselves or in response to difficult circumstances. A desire to be thin and beautiful, and the images we see in the media, may contribute towards the development of an eating disorder – but they are far from the sole factor. In fact some people develop eating disorders in order to try and make themselves look ugly. It is quite common for victims of rape or other abuse to under- or overeat either consciously or subconsciously in order to make themselves less attractive. Additionally, there are many documented cases of anorexia in blind people.

      ‘It frustrates me when people assume that eating disorders are all about appearances. We’re a blind school and have had several cases of anorexia over the years, all in kids who were born unable to see. They’ve never been exposed to the media like their peers, yet they starve themselves. They never talk about what they look like – my understanding is that they are using food as a way of taking control of their lives.’

      Myth: Self-harm and eating disorders are attention-seeking behaviours

      Eating disorders are generally very secretive diseases. People with bulimia can go undetected for many years unless they seek help, whilst people with binge eating disorder often go to great lengths to eat healthily in the company of others and binge only in private. People who are severely anorexic tend to attract a certain amount of attention due to their emaciated appearance, but this attention is often misinterpreted, with the sufferer genuinely believing that people are staring at them because they are fat rather than realizing it is because they are thin.

      Self-harm tends to fall into two broad camps: those who hide their injuries and those who don’t. Those who hide their injuries will often harm parts of the body which are least likely to be detected, such as the stomach or the tops of their arms and legs. These cases can go undetected indefinitely, often only coming to our attention if a disclosure is made. Conversely, some people who self-harm will not attempt to hide their injuries and may be judged as ‘flaunting’ them. Rather than dismissing this as attention-seeking behaviour, we should stop and ask ourselves ‘Why is this student seeking attention? What are they trying to communicate?’ For some students, unable to communicate or seek help for emotional or psychological trauma they have experienced, their only means of seeking help is through a physical injury. Instead of ‘attention seeking’ a more useful way to consider this behaviour is ‘attention needing’ – encourage colleagues not to be so quick to judge but rather to consider what support the individual needs.

      People suffering with self-harm and eating disorders routinely suffer from self-esteem that is so low that they can’t believe that anyone would ever care about them – attention seeking is often the last thing on their mind.

      ‘I would have probably asked for some help sooner if I hadn’t thought my cutting would just be written off as attention seeking. Knowing that people would judge me like that made me very reluctant to talk about what was happening.’

      Myth: People who binge eat should just eat less and exercise more

      Binge eaters have received a bad press for a long time. They are unfairly viewed by many as fat and lazy people who should take control of their diet and try to eat and act more healthily. However, it’s not that simple. For someone who suffers from binge eating disorder, food is often the only mechanism they have for dealing with their emotions and the difficulties they face in their day-to-day lives. Food is like a drug to them; it numbs their pain. They know that they should stop bingeing and will often be thinking about the fact that they shouldn’t binge even as they prepare to do so. However, they tend to lose all

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