Running head: SELF-HARM IN BYU-I STUDENTS 1

Self-Harm in BYU-I Students

Stephanie Knight

Brigham Young University – Idaho

Nurs 433C

Sister Shippen
SELF-HARM IN BYU-I STUDENTS 2

Self-Harm in BYU-I Students

Background

College-aged students have the highest reported rate of self-harm-related emergency

department visits in the United States. According to Healthy People 2020 (2014), 313.1 per

100,000 people eighteen to twenty-four-years-old were admitted to the emergency department

for nonfatal self-harm injuries. Like many other injuries and acts of violence, self-harm is

preventable.

In 2008, Healthy People 2020 (2014) found that 124.9 per 100,000 people were admitted

for intentional self-harm injuries to the emergency department. The Healthy People goal for

2020 is to decrease the incidence of self-harm injuries to 112.4 per 100,000. However, the

incident rates have increased since 2008. In 2015, an average of 162.4 per 100,000 people in the

United States were admitted for intentional self-harm. Individuals between eighteen and twenty-

four years of age have shown incidences of intentional self-harm to be greater than other age

groups. In 2015, eighteen to twenty-four-year-olds had an incidence rate of 313.1 per 100,000, a

rate which exceeds previous years (Healthy People 2020, 2014).

Population

The population being assessed are eighteen to twenty-four-

year-olds of all ethnic backgrounds, male and female, who attend

Brigham Young University-Idaho (BYU-I) on campus. Students of

this age group compose 85% of on-campus students and 14% of

online students (BYU-Idaho Academic Office, n.d.). The student

body includes a total of 34,232 students attending BYU-I in the

Winter 2018 semester. Approximately 84.90% of these students

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are Caucasian, 3.53% are Hispanic, 0.46% are Pacific Islanders, 0.61% are African American,

1.09% are Asian American, 0.31% are American Indian, 1.52% are of unknown ethnicity, and

7.58% claim two or more ethnic heritages. About 22,719 on-campus students are married.

Roughly 99% of BYU-I students are members of the Church of Jesus Christ of Latter-Day Saints

(LDS) and 16,973 students have returned from serving a mission for the LDS church (BYU-

Idaho Academic Office, n.d.).

Community

People

The city of Rexburg has a population a little over 30,000, 40.6% of whom are between

the ages of twenty and forty-five. The high percentage of the population in this age range is due

to the fluctuating number of students coming and going from BYU-I. Since Ricks College

transitioned to Brigham Young University-Idaho in 2004, the population has grown by 32%

(City of Rexburg, 2018). Students attend this university from different nations and American

states, but English is still the main language spoken. With 99% of incoming students being LDS,

the majority of the community is made up by LDS members. The Church of Jesus Christ of

Latter-Day Saints has many beliefs that set it apart. First, they believe that divine authority has

been reinstated to the Earth through the prophet Joseph Smith in the 1800s. Second, instead of a

single being, the trinity is believed to be three separate entities whom the LDS people refer to as

“the Godhead.” Third, there are modern prophets today and revelation continues. Fourth,

temples build eternal families. And fifth, through the Plan of Salvation, mortals have been sent

to earth to be tested and to receive heavenly glory in the next life (Church of Latter-Day Saints

Newsroom, 2011).
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Place

BYU-I campus can be found in Rexburg,

the county seat of Madison County (City of

Rexburg, 2018). Rexburg was founded alongside

the Teton River by a group of LDS pioneers in

March 1883. With the founder’s focus being

family and education, Rexburg quickly developed

into a college town. The name Rexburg originates

from one of the pioneer leaders: Ricks. The two-

year college built there was also named after this

leader until it became a full four-year university and was renamed Brigham Young University-

Idaho. In the present day, Rexburg is located nearby Highways 20 and 33 and Interstate-15.

Areas such as Yellowstone National Park, Teton National Park, and the Sand Dunes of St.

Anthony, are recognized on a national level and lead to year-round outdoor activities (City of

Rexburg, 2018).

Function

Institutions in Rexburg include BYU-Idaho, Madison Memorial Hospital, a handful of

retirement homes, a significant number of mental health facilities and professionals, the public

library, and more (City of Rexburg, 2018). Most

community-hosted events revolve around outdoor

activities such as marathons, concerts, and summertime

farmer’s markets. Rexburg continues to follow its founders’ values of family and education, as
SELF-HARM IN BYU-I STUDENTS 5

seen when families begin to develop while students pursue education. The city also encourages

the development of business to increased economic investments and growth.

Plan

Generating Data

Key informants will include interviews with emergency department nurses and their

experiences with self-harm patients, and BYU-I students who have struggled with self-harm.

The windshield survey will include observing the number of mental health facilities in

the community and the transportation necessary for BYU-I students to access them. Other

factors to include would be student access to vehicles, placement of living quarters, ethnicities,

and social practices.

Gathering Data

For this project, I intend to use data gathered From Healthy People 2020, the US Census

Bureau, the Center for Disease Control (CDC), Web-based Injury Statistics Query and Reporting

System (WISQARS), the Robert Wood Johnson Foundation (RWJF), demographic statistics

from BYU-Idaho, American Association of Suicidology (AAS), a windshield survey of Madison

County, and interviews of individuals who have experienced the effects of self-harm as an

individual, a healthcare professional, or family member.

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Assessment

Primary Data

Key informant. As part of the assessment and gathering of data, it was planned to

interview individuals who have experienced the effects of self-harm on the levels of harmed

individual, a family member, and a healthcare professional to gain insight on self-harm and the

challenges faced in its treatment.

Healthcare Professional

About what percentage of patients come in I would only work one day a week. When I worked, it wasn’t

because of self-harm related injuries? a lot. Maybe 10%. We get a lot of intentional overdosing too.

I once had three people come in with cutting. One girl’s

wound was so deep it was flaying.

How many of these patients are between 18 A lot. Sixty to seventy percent were college-aged. You see a

and 24 years of age? lot of self-harm injuries from eighteen into the thirties.

What protocols does your facility have in When they come in, they are screened. If the doctor thinks

place to help self-harm patients that end up in there is any more harm that could happen, they do a

the ED? behavioral consult with a BHC worker by telehealth. They

determine if they need inpatient care or something else. We

also have a daytime social worker who is always there, so she

could see them too.

How many college students utilize your We don’t go a shift without seeing college kids. Most students

facility as a resource? have the student health center, but if that is closed, they don’t
 SELF-HARM IN BYU-I STUDENTS 7

know another resource but to come to the hospital. We also

have a lot of students from California and most doctors here

won’t take their insurance, so students have to come to the

ED.

What things does your facility do for patients We have a packet in the ED that is a list of resources for them.

that struggle with self-harm? A lot of what we do is to talk to them, see what their struggles

are, and get them hooked up with the right resources.

Self-Harmed

When did you start with self-injury? Late 2013 is when it started. It continued to mid-2014.

Did you ever go to the hospital for a self- Not specifically, but it was one of the reasons I went to the ER

inflicted injury? before going to the mental hospital. I also had a few more

after I was discharged from the mental hospital, and they

readmitted me for a few more days. There were a few self-

inflicted injuries after that, but I didn’t go the ER for them.

What support did you receive from family? In a lot of ways, I felt unsupported. I could tell people were

trying to be supportive. For example, my mom would get mad

at me if she found out I was cutting instead of being

empathetic and supportive. I felt I was being chastised rather

than being supported. I felt more supported by my brother and

sister who were closest to me in age.

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What support did you receive from In September 2014, I had a roommate. I received almost no

roommates/friends? support from him. He was kinda cold to me, which made it

really hard. I had another friend, Lenny, who helped a lot.

Did you attend, or were you aware of, any I did not know of any community resources other than the

community services that would have helped mental hospitals. I didn’t even know the mental hospital was

you? If yes, in what way did those services an option until I was hospitalized the first time.

influence you?

Roommate

How did you learn that your roommate was The cops came over at two in the morning. She knocked on

instigating self-harm? my door and asked me to come into the Livingroom. The

police had come over and they told her she wasn’t allowed to

be by herself. She had to be with someone she trusted, so she

knocked on my door.

What did you do in response to this In my room I was annoyed at first. I wanted to know why she

information? had males in our apartment at two in the morning. I also had

to put a shirt on over my tang top and that annoyed me too.

Seeing the cops, I sombered and knew ‘oh, this is something I

need to take seriously. I need to give all of my attention to

this.’
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Did you feel prepared to help them? Why or Nope. I don’t think anyone’s fully prepared for any big issue,

why not? whether it be suicide or not. I don’t think I would’ve done

anything different. I still would have taken away the

temptations and driven her to her therapies—even though it

was forced, I would have done it—I would have gone with her

to the bishop’s if she had asked me to.

Where did you go to learn the skills to help Don’t let the temptation be there. If someone is an alcoholic,

them? you take away the alcohol. If someone self-harms themselves,

you take away the razors. I didn’t have formal training, it was

just logical. The cops said to not leave her alone. I think it

might be easier to deal with situations like this when you’re

confident in yourself, so you don’t get pulled down. It can be

easy to be pulled down into a depressive state, so I needed my

defenses up as well. I needed to detox and become strong

again when she went to bed.

What programs are you aware of in the I knew nothing. I knew bishop, the cops, and of her therapist.

community that helps self-harm patients? I only knew the cops were there because they said they were. I

knew I could go to the bishop and he said, ‘here is a

counselor.’

Family Member
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How did you learn that your family member I didn’t know until my parents were driving my brother off to

was instigating self-harm? the ER in the middle of the night.

What did you do in response to this I had a roommate in the past who struggled with self-harm,

information? but it still didn’t help me when my brother was pulled out the

door to go to the ER.

Did you feel prepared to help them? Why or I didn’t feel totally prepared, but I knew that patience and

why not? empathy would be important for him.

Where did you go to learn the skills to help I had a roommate who struggled with self-harm. I had no idea

them? what I was doing then and was zero help. I never had any

formal training or read anything to help me. It didn’t even

cross my mind.

What programs are you aware of in the Mental health wasn’t really on my radar until this happened. I

community that helps self-harm patients? knew of two therapy offices in the city afterwards, and that

there were a few mental hospitals in the area, but nothing else.

Windshield Survey

For this windshield survey, the number of student apartments in relation to the number

and location of mental health facilities were considered. According to BYU-Idaho housing

policies, all non-married students must live in approved housing. Such approved housing can be

found throughout Rexburg, but most remain within a two-mile radius of the college campus

(Google Maps, n.d.). However, most mental health services are located a half or two miles away
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from campus. With a car, travel time may only amount to ten minutes. For students without

access to a car, this can easily become a thirty-minute walk unless they use the Health Center on

campus. The following Google Map shows the mental health facilities closest to BYU-I campus:

(Google Maps, n.d.).

Secondary Data

Demographics. Matt Wray, a professor of sociology at Temple University explains that,

while most people who die by suicide are in psychological distress, the causes behind that

distress is often social or economical (Wray, 2012). The United States Census Bureau indicates

the level of poverty in Rexburg was 43.2% in 2016 (Census Bureau QuickFacts, n.d.). The
SELF-HARM IN BYU-I STUDENTS 12

United States Census Bureau (2017) explains the poverty threshold for an individual under the

age of 65 without any children is a total income of 12,752 American dollars in a year. In 2010,

the CDC calculated that approximately 2,610.8 people lived in each square mile of Rexburg’s

9.76 square miles. Between the large student population and the condensed square footage of

Rexburg, the most likely source of Rexburg’s 43.2% poverty are the students living in the area.

Government agencies. According to the Robert Wood Johnson Foundation (RWJF), the

western side of the United States has a greater inclination toward self-harm and suicide

compared to other areas in the country (Robert Wood Johnson Foundation, 2013). After

exploring this phenomenon, RWFJ extrapolates that the population of western US states is more

prone to population changes due to the increased number of newcomers and temporary residents.

Because the population is ever-changing, there are fewer opportunities for individuals to form

social bonds. Social bonds and connections is a less-explored variable of self-harm and suicide

but may prove to be a major component after further study is completed (Wray, 2012).

The Web-based Injury Statistics Query and Reporting System (WISQARS), which

condenses statistics from the Center of Disease Control (CDC) shows a similar pattern to

RWFJ’s findings. Like RWFJ’s claims, rates for death by suicide are higher in the west and

mid-west states when compared to the eastern United States (WISQARS, 2017). The following

graph shows death rates by state:

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(WISQARS, 2017a).

Other data. The American Association of Suicidology (AAS) is a non-profit

organization that assesses and records rates of suicide and self-harm across the nation. In 2016,

they released a fact sheet regarding college students and suicide rates. According to this report,

suicide is the second most common cause of death in undergraduate students (AAS, 2016). In

Madison county between 2008 and 2014, 20.41 to 26.39 per 100,000 deaths occurred

WISQARS, 2017b). This rate is higher than many counties in Idaho. The following graph

exemplifies this stratification:

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(WISQARS, 2017b).

Most undergraduate students in the United States fall between eighteen and twenty-four-

years-of-age and more commonly report suicidal and self-harm ideations that graduate students

(AAS, 2016). About 31% of undergrads have considered suicide seriously (AAS, 2016).

Approximately 9% of US college students have attempted suicide and 77% of Caucasian

college-aged students died from suicide in 2014 (AAS, 2016). However, many studies have

shown that most undergraduate students who report suicidal thoughts belong to ethnic minorities.

AAS further reports that, despite a growing demand for psychiatric health facilities, 86% of

undergraduates who died from suicide did not seek counseling services before their deaths (AAS,
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2016). Additionally, 30.4% of college students that do attend counseling dropout prematurely

(AAS, 2016).
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Data Interpretation

Similarities

The first common theme among these sources is found among the key informants, many

of whom expressed feelings of unpreparedness. Many interviewees explained a lack of

knowledge regarding what they could do for the self-harmed individual in their lives and were

unaware of any community sources that could help them. Second, many of the professional

online sources had a theme surrounding the fact that there is an increased likelihood of self-harm

and suicide associated with economic struggles, which have been commonly found among

undergrad students between eighteen and twenty-four-years-of-age (Census Bureau QuickFacts,

n.d.; Wray, 2017). Third, many sources reported an increased likelihood for self-harm and

suicide among this population when social structures fluctuate (Census Bureau QuickFacts, n.d.;

Wray, 2017). This fluctuation is commonly seen each trimester at BYU-I as students arrive and

depart based on individual track assignment (City of Rexburg, 2018). With this change in

attendance comes a change in roommates and the presence of friends, thus changing whatever

support system may exist.

Differences

From the windshield survey, it is apparent that not all students are on the same level of

need. Not all students have access to private insurance, but they can receive insurance from

BYU-Idaho’s health center (BYU-I, 2018). Health insurance, whether through family or through

the school, is mandatory for each student and covers services in the health and counseling

centers. A second difference can be found in varying levels of financial stress. Many students

experience high levels of stress from school expenses but appear to vary in financial support

from family or in the ability to support themselves. This will not be the case for all students,
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however. Competition for employment is steep in Rexburg, so not all students will be able to

find work. A final difference found among the sources used in this study is the difference

between Emergency Room visits in the Rexburg area compared to the rate calculated by Healthy

People 2020 (2014). This may be due to shifts in population or decreased transportation to the

hospital.

Population strengths

This population has great potential to find strength. The potential for support in this

community is diverse. Google Maps (n.d.) shows a plethora of mental health facilities in the city

of Rexburg alone. One mental health facility within walking distance is the counseling center on

BYU-Idaho campus (BYU-I, 2018). Additionally, as stated by interviewees, bishops from the

LDS community and roommates can serve as support systems when possible. Within the LDS

church is a support system now known as ministering, which encourages a team of two

individuals to meet with their assigned persons at least once a month (Church of Jesus Christ of

Latter-Day Saints, 2018). For students who do not have access to health care through work, their

family, or other sources, health insurance is even available through BYU-I (BYU-Idaho, 2018).

With this insurance in place, students are able to receive healthcare services through the

university’s health center and counseling center (BYU-Idaho, 2018).

Population challenges

With strengths, however, there are challenges. There are many mental health facilities,

but, as shown by Google Maps (n.d.), not all are within walking distance and many students do

not have available transportation to get there. BYU-Idaho’s health center houses a counseling

center, which is easily within walking distance. However, there is commonly a waiting list

involved, which delays access to speaking with a counselor (BYUI, 2018). Additionally, due to
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the ever-changing student population, social supports change based on the current trimester at

BYU-I (City of Rexburg, 2018). The community provides a variety of free classes. One

example of community resources includes mental health training seminars held by Madison

County (Madison Cares, 2016). Despite the available resources and training provided by the

community, not many people are aware of them and cannot use them as a result, as seen in

discussion with key informants.

Validating information.

Undergrad students eighteen to twenty-four-years-old have the highest reported rate of

emergency department visits for nonfatal, self-inflicted injuries in the United States. The rate of

self-harm for all people in the United States has increased from 124.9 per 100,000 people in

2008 to 162.4 per 100,000 in 2015 (Healthy People 2020, 2014). The exact cause for this

increase in self-harm is unknown, but many professionals have considered potential factors.

Wray (2012) indicated that economic stress increases likelihood of self-harm and suicide.

Approximately 43.2% of Rexburg’s population is considered to be poverty-level poor, likely due

to the high concentration of college-aged students (United States Census Bureau, 2017).

In general, western American states seem to have higher levels of population fluctuation,

a phenomenon which is exemplified in Rexburg, Idaho (City of Rexburg, 2018; RWJF, 2013;

WISQARS, 2017). This fluctuation leads to decreased solidity of social bonds, which is a vital

component in reducing the rate of self-harm (Wray, 2012). RWFJ (2013) extrapolates this

population fluctuation is a factor to the increased rates of self-harm in western American states.

Madison County, specifically, has a death-by-suicide rate that is higher than many counties in

Idaho (WISQARS, 2017b). While there may be many resources available to help people who

struggle with self-harm, interviewees express an unpreparedness and lack of knowledge

SELF-HARM IN BYU-I STUDENTS 19

regarding how to help self-harmed individuals and the community resources which are available

to assist themselves and the self-harmed individuals in their lives.

SELF-HARM IN BYU-I STUDENTS 20

Population Health Plan

Access

Area of improvement. Access to healthcare facilities, whether by physical location or

due to insurance complications, is a struggle for this population. There does not seem to be a

single way to resolve this barrier since there are many possible factors. BYU-Idaho, however,

approaches the issue by having a counseling center on campus, which is within distance for most

on campus students (Google Maps, n.d.). Additionally, the regular charge rate is around ten

dollars per meeting, so the financial struggle is greatly reduced (BYU-Idaho, 2018). Healthy

People 2020, however, alludes to the high prevalence of he problem related to the size of the

study population that may benefit from treatment. An average of 162.4 per 100,000 people were

admitted to the ED for self-inflicted injuries and the highest known population for self-inflicted

injuries are between eighteen and twenty-four-years of age (Healthy People 2020, 2014). A bulk

of the university’s students, about 85%, are on campus students (BYU-Idaho Academic Office,

n.d.). Due to the large population in potential need of services, the university may not be able to

see all students who suffer from thoughts of or actual self-harm.

Recommendations. It is not probable for a single facility to provide cares for 85% of a

university’s populace. BYU-Idaho may not be able to expand due to lack of university funding,

but it may be possible for current healthcare professionals from the BYU-Idaho’s Counseling

Center to refer students to other facilities and healthcare professionals. These BYU-Idaho

mental health professionals could assess and refer individuals who struggle with self-harm to

other community facilities. This transfer of cares may be based on the individual’s access to

transportation, the student’s insurance coverage, and the level of expertise they may require.
SELF-HARM IN BYU-I STUDENTS 21

Evaluation. By involving other facilities, rates of success may be more difficult to

assess. However, the AAS (2016) have shown that 30.4% of individuals with suicidal ideation

of self-harm tendencies tend to drop out of counseling early. Assessing the levels of retention

between the school and the outsourced community facilities may prove beneficial in tracking

outcomes.

Education

Area of improvement. Many eighteen to twenty-four-year-olds are undergoing a major

life change and lack the skills necessary to cope. They are moving away from home, perhaps for

the first time, and trying to determine what they will do for the rest of their lives. In addition to

schooling, undergrad students of this population may also be trying to make decisions regarding

marriage, religious identity, and more.

Recommendations. Mental health is an ongoing and prevalent struggle for many people

on an individual or familial level. These studies have expressed a lack of comprehension and

coping skills among individuals. One way to combat this lack of knowledge would be to include

a section on mental health within health classes that are routinely performed at middle and high

school levels. These recommendations may reduce rates of self-harm in the future, but it does

not address the current challenge.

For the present, community classes may be held, and advertised, on BYU-Idaho’s

campus. This would allow easier access to on campus students, and to increase student and

faculty awareness of community resources for mental health struggles.

Evaluation. The benefits for including mental health lessons in middle and high schools

may be measured by future rates of self-harm found among undergraduate college students

between eighteen and twenty-four-years of age.

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For the nearer future, success of community classes may be fulfilled in a variety of ways.

Surveys may be sent out via student emails to assess student awareness of the classes and to

assess feelings of preparedness for those who have already attended. Such surveys may also

further increase awareness and attendance of such classes.

Support

Area of improvement. This population is at high risk for a lack of support.

Approximately 40% of this population is suspected to fluctuate by the comings and goings of

students throughout BYU-Idaho’s trimesters (City of Rexburg, 2018). Most students are away

from family, may not know their roommates before moving in, or have friends living elsewhere

nearby. Church leaders in young single adult (YSA) wards may be more constant, but may lack

training in mental health or awareness of the challenges faced by this population.

Recommendations. A supportive network is highly beneficial for all individuals; this is

especially the case for individuals who struggle with mental health on any level. Individuals

who have a person in their life who struggles with mental health should be encouraged to seek

out education to both understand the struggle, and to learn the skills necessary to help. Support

groups like the “big brother” and “big sister” programs could be initiated. In place of a brother

or sister, struggling individuals could be matched with a person who is trained in mental health.

This would be a resource for support, and the supporter could act as an advocate for the

individual struggling with mental health.

Individuals in leadership positions, whether they lead adults or youths, could be

encouraged to take a course on aiding others with mental health. This may have noticeable

benefits for youths, considering the highest rate of self-harm and suicide falls between

adolescence and twenty-four-years-old (AAS, 2016).

SELF-HARM IN BYU-I STUDENTS 23

It is imperative for community members to continue learning therapeutic

communications and compassion for those who may be struggling. With the knowledge that

comes from ongoing mental health training, individuals can act as advocates and as a column of

support for individuals who may not have support otherwise. Additionally, those who have been

educated can help further by teaching others in a casual capacity. It may not be possible for

everyone to receive intensive or basic mental health training, but it is possible to be of help when

educated with a handful of facts.

Evaluation. A practice group could be formed and studied to determine the viability of a

“big brother” or “big sister” program. Such tests will require follow-up and a comparison to a

group who did not spend time with a “big brother” or “big sister.” Surveys may be conducted

among YSA wards to assess individual and church leader awareness of those who struggle with

self-harm in their ward.

Reflection

From this project, I have learned that the best way to help and approach individuals who

struggle with mental health is to seek education and understanding. Mental illness is often very

taxing for all persons involved and requires a lot of patience, especially for those who engage in

self-harm. As a professional, I need to be aware of how I think about patients who struggle with

self-harm. Bias is detrimental to building a healthy and trusting patient-nurse relationship. A

patient who struggles with self-harm requires the same level of bias-free care found in substance

abuse, suicidal ideation, and other mental or physical maladies.

I can apply my learning to improve the lives of others by spreading the things I have

learned. In my future career as a healthcare professional, I can assist with or hold classes

regarding mental health and self-harm. For now, I can use what I have learned to improve the
SELF-HARM IN BYU-I STUDENTS 24

lives of individuals close to me. There are many self-harm patients found in mental health

hospitals. As I continue my work there, I can pursue patient and family education. All

individuals require a support system, but self-harmed individuals require it to a greater degree.

Education and support have been my greatest areas of concern for patients who struggle

with mental health and self-harm since I found two important people in my life struggle with

these things. For years, they also struggled alone. I had no idea they were struggling, and when

I was aware, I didn’t know what to do. Many people feel helpless when faced with the prospect

of someone harming themselves or worse. Mental health is not something that American

schools, elementary through university, are well-versed in. It leaves struggling individuals, and

the people who could form their support groups, floundering for some way to cope. Personal

experience taught me these things. This project emphasized the importance for community

awareness and involvement. No single individual can fix a community. However, a community

of individuals may be able to succeed where lone individuals fall short. Mental health should be

as common as traditional first aid in order for it to be successful. This knowledge may start with

individuals, but with the right advertising and classes, a whole community may find a solution.

Reflection Word Count: 377

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References

American Association of Suicidology. (2016). College Students & Suicide Fact Sheet 2016 Fact

Sheet. [Online]. Retrieved from: http://www.suicidology.org/Portals/14/Re-

Formatted%20College%20Students%20Fact%20Sheet.pdf?ver=2016-11-16-110354-547

BYU-I. (2018). Counseling Center. Retrieved from http://www.byui.edu/counseling-center/

BYU-Idaho. (2018). Student Health Plan. Retrieved from http://www.byui.edu/health-

center/student-health-plan

BYU-Idaho Academic Office. (n.d.). Official Enrollment Statistics. Retrieved from

http://www2.byui.edu/IR/stats/index.htm

Census Bureau QuickFacts. (n.d.). U.S. Census Bureau QuickFacts: Rexburg city, Idaho.

[Online]. Retrieved from:

https://www.census.gov/quickfacts/fact/table/rexburgcityidaho/LFE041216#viewtop

Church of Jesus Christ of Latter-Day Saints. (2018). Ministering: Frequently Asked Questions.

Retrieved from https://www.lds.org/mycalling/ministering-faq?lang=eng

Church of Latter-Day Saints Newsroom. (2011, May 12). Learn About Core Mormon Beliefs.

Retrieved from https://www.mormonnewsroom.org/topic/core-beliefs

City of Rexburg. (2018). Home. Retrieved from http://rexburg.org/pages/home

Google Maps. (n.d.). Mental Health Facilities by BYU-I [Map]. Retrieved from

https://www.google.com/search?rlz=1C1CHBF_enUS752US752&q=mental health

facilities by byui&npsic=0&rflfq=1&rlha=0&rllag=43816581,-

111787559,702&tbm=lcl&ved=0ahUKEwj99rerhKzbAhUIwlQKHW8TBJMQtgMIKw

&tbs=lrf:!2m4!1e17!4m2!17m1!1e2!2m1!1e2!2m1!1e3!3sIAE,lf:1,lf_ui:2&rldoc=1#rlfi

=hd:;si:;mv:!1m3!1d13372.579831818806!2d-
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111.78755994999999!3d43.82674295!2m3!1f0!2f0!3f0!3m2!1i108!2i223!4f13.1;tbs:lrf:!

2m1!1e2!2m1!1e3!2m4!1e17!4m2!17m1!1e2!3sIAE,lf:1,lf_ui:2

Healthy People 2020. (2014). Injury and Violence Prevention. Retrieved from

https://www.healthypeople.gov/2020/topics-objectives/topic/injury-and-violence-

prevention

Madison Cares. (2016). Madison Cares. Retrieved from http://www.mymadisoncares.com/

Robert Wood Johnson Foundation. (2013). Solving the Riddle of the U.S. ‘Suicide Belt’.

[Online]. Retrieved from: https://www.rwjf.org/en/library/articles-and-

news/2013/06/solving-the-riddle-of-the-u-s--suicide-belt.html

United States Census Bureau. (2017). Poverty Thresholds 2017. [Data file]. Retrieved from:

https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-

thresholds.html

Web-based Injury Statistics Query and Reporting System. (2017a). [Graph illustration United

States Death Rates]. 2008-2014, United States Death Rates per 100,000 Population.

Retrieved from https://wisqars.cdc.gov:8443/cdcMapFramework/output/m5078083.png

Web-based Injury Statistics Query and Reporting System. (2017b). [Graph illustration Idaho

Death Rates]. 2008-2014, Idaho Smoothed Death Rates per 100,000 Population.

Retrieved from https://wisqars.cdc.gov:8443/cdcMapFramework/output/m9669239.png

Wray, M. (2012). Examining Suicide from a Population Health Perspective. [Online]. Retrieved

from: https://www.rwjf.org/en/blog/2012/06/examining-suicide-from-a-population-

health-perspective.html