Supporting children and young people who self-harm

What is self-harm?

Self-harm, often called self-injury, is a serious mental health condition where a person intentionally harms their own body and may include acts such as cutting, scratching, burning, biting and scalding.  It may also include the ingestion of objects or substances in order to deliberately injure oneself in an attempt to help manage feelings of emotional pain, anger and frustration.  These injuries, when inflicted on the body, might lead to a momentary sense of release and calm but it is often followed by feelings of guilt and shame contributing to a cycle of negative thoughts, feelings and emotions.  As such, self-harm can also be viewed as a coping strategy and an indicator that a child or young person is struggling emotionally. 

There is little evidence to link self-harm with thoughts of suicide and self-harm might be viewed as the child or young person struggling to deal with life rather than attempting to end it.  But parents and carers will understandably worry about their child hurting their body and the potential for infections or life threatening injuries, therefore it is imperative to seek professional help and treatment.

Signs that a child or young person is self-harming

Self-harm is often done in secrecy and on areas of the body which are easier to hide through clothing, such as the upper arms and thighs.  This may mean it is easy to miss at first.  However, parents and carers might start to notice unexplained scarring or cuts which may even resemble patterns on their child’s body.  Their child may repeatedly report injuries caused by random ‘accidents’ to try to explain noticeable scratches or bruises and the frequency of these instances might raise a red flag and indicate that there’s something more to be concerned about.  Self-harmers may also carry around sharp objects such as pocket knives which you may discover in their room or clothing alongside bloody tissues or towels. 

It is important to remember that self-harm is a symptom of other issues, such as anxiety or depression, which may present as erratic mood swings, including anger and frustration, low self-esteem and increased use of language which indicates worthlessness, hopelessness, and helplessness.  Identifying the emotional struggle which compels a child or young person to self-harm may help minimise the risk of further self-harm but this may be a long process which requires professional help.  It is, therefore, important that you consult with your child’s GP for a referral to help your child once you are aware of the problem.

Common issues parents and carers may have to contend with

It can be challenging for parents and carers to know that their child is injuring themselves and that there may be very little they can do to prevent it.  They may instinctively want to tell their child to simply stop hurting themselves, but this is rarely effective as it dismisses a strategy which the child or young person finds helpful and has control over and could lead to further withdrawal and increased harm. 

Parents and carers may face similar conflicts and can often feel like they are walking on a tightrope between trying to address the issue and risking their child becoming more upset and harming themselves.  Will, for example, removing a sharp object prevent harm or risk being replaced by something more unsafe?  Will letting a child or young person know that you’ve found blood on their clothing open conversation or push them away from you?  What is the balance between keeping your child safe and overly monitoring or policing them?  How can you ensure your child’s injuries don’t become infected if they refuse to seek treatment?  These are all difficult questions to have to think through in the moment, so seeking professional advice and guidance is essential for both you and your child. 

How to support a child or young person who is self-harming

As there is a lot of shame attached to self-harm, it may take time for a child or young person who self-harms to open up to you even if they’re aware that you know they self-harm.  Practicing patience is therefore important. 

Try not to bombard you child with questions but ensure they know that you love them and that their wellbeing, both physical and mental, is extremely important to you.  There may be healthier coping strategies, such as those on our self-care page, which your child could be made aware of and hopefully try to use when they feel like harming themselves and some of the strategies, such as writing things down, may help them communicate to you some of the underlying problems that makes them want to harm themselves in the first place.  This may take the pressure off talking to you about these issues direct which may help keep the conversation calm and open.

Difficult though it may be to talk to you a child or young person about self-harm, it is important to seek help for them and to let them know that you have organised this for them.  As self-harm can be traumatising for all the family, you may also want to consider what support is available to you and other members of the family.

What to say to schools and colleges

Self-harm is a serious mental health problem and can be difficult for schools and colleges to handle at times. However, it is important to notify your child’s school to ensure that they know that your child is vulnerable and potentially at risk. Teachers may find it hard to speak to students about self-harm but, as with parents and carers, talking about the issue won’t cause more harm but may remind the child or young person that there is a wide circle of support available to them should they have thoughts of self-harming.  Showing concern is often more useful than trying to tell a child to stop self-harming which is often ineffective and should be discouraged as should disclosing the issue to other students which is often not helpful and could lead to bullying or gossip.

It is important for parents and carers to communicate with schools and for teachers and the wider pastoral team to know what to do if self-harming has occurred.  This may include calling 999 for an ambulance if they fear a child has overdosed or has caused serious bodily harm.  Most self-harm isn’t linked to suicidality but if a staff member is told that a child or young person wants to die they have a care of duty and safeguarding responsibility to report this and parents and carers should enquire as to the schools policies regarding this practice and understand the legal processes schools and colleges must conform to.

What to say to siblings?

It can be a very debilitating and traumatic experience for siblings to witness someone self-harming and parents and carers should take steps to try to minimise exposure. Younger children could be extremely frightened by the thought of their brother or sister self-harming so parents and carers should be mindful not to be too descriptive when talking to them.  Older siblings may also be shocked and frightened but should be able to process the realities of self-harm and be encouraged to talk openly and ask questions about anything they see or witness.   

Siblings sometimes end up feeling frustrated and might even feel that the child is engaging in self-harm to seek attention. However, it is important for parents and carers to make sure siblings are aware of the seriousness of the situation and don’t do or say things that could make it worse for the child or young person. Siblings may also require professional help to process any trauma they experience.

What to say to extended family?

There is a lot of stigma attached to self-harm. It is often seen as a weakness or an attention-seeking act. Parents and carers need to have an open conversation with their child to find out if they are comfortable with the extended family finding out as it might bring undue attention and make things worse for them. Extended family can be informed of the fact that the child is struggling without giving all the details though if a child visits relatives regularly, particularly if they stay overnight, then parents and carers should consider making them aware of the self-harm so as to be prepared should an incident occur.

As a family it can be very frightening and exhausting supporting someone who self-harms. Whilst the focus should be on supporting the child, parents and carers should be aware of impact on all members of the family including themselves and seek professional help or support where necessary.

Additional support for parents and carers

• Harmless – advice and guidance

• Self-harm UK – advice and guidance

• Life-signs – advice and guidance