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Knowledge Base » Mental Health » Supporting young people who self harm

All about Supporting Young People who Self-Harm

Last updated on 20th December 2023

According to Young Minds, in 2018 and 2019, 24% of 17-year-olds were reported to have self-harmed in the previous year, and 7% were reported to have self-harmed with suicidal intent at some point in their lives. Nearly half of 17- to 19-year-olds with a diagnosable mental health condition had self-harmed or attempted suicide at some point.

In 2021, among children aged 6 to 16 in England, one in six had a probable mental health condition; this is an increase from one in nine children in 2017. In 2021, 24% more patients were in contact with the children and young people’s mental health service (CYPMHS) compared with 2020, and 44% more than in 2019. This included patients who were waiting to be seen.

What is self-harming?

Self-harm is when someone purposely hurts themselves as a way of coping with very difficult memories, painful feelings and emotions or overwhelming experiences. There are lots of different forms of self-harm. Some people self-harm in the same way all the time, while other people hurt themselves in different ways at different times.

Young people may self-harm by:

  • Cutting themselves.
  • Poisoning themselves.
  • Biting themselves.
  • Picking their skin.
  • Burning their skin.
  • Hitting themselves with objects.
  • Pulling their hair.
  • Overeating or undereating.
  • Having unsafe sex.
  • Getting into fights.
  • By using alcohol, drugs or medication.
Picking skin as a form of self harm

Why do some young people self-harm?

Some young people may self-harm for the following reasons:

  • To reduce painful, overwhelming emotions, thoughts or feelings.
  • To turn emotional pain into physical pain.
  • To express something which is hard to explain in words.
  • To relieve tension and pressure, or reduce feelings of panic and anxiety and temporarily feel calmer.
  • To feel in control.
  • To cope with traumatic memories.
  • To punish themselves if they have feelings of guilt or shame.
  • To stop feeling numb or disconnected/dissociated from their own situation.
  • To let people know that they are feeling suicidal without actually taking their own life.
  • Experiencing depression, anxiety or eating disorders.
  • Having low self-esteem.
  • Being bullied or feeling isolated.
  • Experiencing a bereavement. For further reading about bereavement, please see our knowledge base.
  • Experiencing any kind of trauma.
  • Having physical health difficulties or a disability.
  • Drug and alcohol use in children. For further reading about this, please see our knowledge base.
  • Experiencing abuse – this can include physical, emotional or sexual.

If you are worried that any child is being abused, or if a child discloses something to you that you are worried about, you can speak to the NSPCC who will be able to offer advice and tell you how you can report your concerns.

Depression in young people can lead them to self-harm. Depression is a mood disorder that causes a persistent feeling of sadness and low mood. It can also cause people to feel irritable or hopeless. It can also be called major depressive disorder or clinical depression. Depression can affect how someone thinks, feels and behaves and can lead to a variety of emotional, behavioural and physical problems.

It may affect their ability to sleep well, their appetite or their relationships with other people. Depression can also cause young people to lose interest in hobbies or activities that they used to enjoy. In severe cases, depression can lead to thoughts of suicide or self-harm.

Anxiety is one of the most common mental health concerns for children and adults alike. While it is normal for children to feel worried or anxious occasionally, for some children anxiety can be more serious and can impact on their day-to-day lives. Anxiety is a feeling of unease, a feeling of worry or fear that can range from being mild to severe.

Anxiety is usually experienced as a combination of physical sensations, thoughts and feelings. Anxiety can feel like you are constantly worrying about things, you have a sense of dread and you may have difficulty concentrating. Young people who have anxiety may also use self-harm as a way of coping with their mental health.

After self-harming, a young person may feel a sense of release which is very short term and the underlying reason they have self-harmed will still be there.

Social media use has also been linked to having a negative impact on children’s mental health in some cases. Internet use can expose children to dangers, such as cyberbullying, online grooming and sexual abuse.

Children can easily be exposed to unsuitable, or harmful, materials online which can cause emotional harm. Think U Know provide some helpful online safety advice and resources. NSPCC also offer a helpful resource for parents and carers with advice on how to keep children safe from bullying and cyberbullying.

Signs of self-harming in young people

The signs that a young person is self-harming may be difficult to spot; however, there are some important things to look out for.

These include:

  • Covering their skin, for example by wearing long sleeves a lot of the time, especially in warmer weather.
  • Unexplained cuts, burns or other marks on their body.
  • Outbursts of anger, or risky behaviour like drinking or taking drugs.
  • A persistent sadness or low mood.
  • Being grumpy or irritable often.
  • Often feeling tired and exhausted.
  • Having trouble sleeping or sleeping more than usual.
  • Having little interest in things they previously enjoyed.
  • Being unable to concentrate.
  • Not being as sociable with friends and family.
  • Low confidence or self-esteem.
  • Talking about feeling guilty or worthless.
  • Feeling empty or inability to feel or express emotions.
  • Eating less than usual or overeating.
  • Noticeable changes in weight.
  • Regular physical symptoms, for example, headaches or stomach aches.
  • Difficulties coping at school.
  • Difficult or angry/aggressive behaviour.
  • Bleak and pessimistic views of the future.
  • Having panic attacks.
  • Having thoughts of suicide.

These signs do not necessarily mean that a young person is self-harming, but they may indicate that the young person is struggling emotionally, and is in need of support.

Young person showing signs of self harm

How can schools help young people who self-harm?

Schools have an important role to play in identifying and helping students who are self-harming.

This includes:

  • Training staff – This should include how to spot the warning signs of a young person who is self-harming and how to respond appropriately.
  • Developing a protocol for responding to self-harm – This can include notifying parents, having appropriate mental health support available, and providing ongoing support.
  • Creating a safe and supportive environment – Schools should strive to create a safe and supportive environment where students feel comfortable and safe talking about how they feel and seeking help when they need it. This can be achieved by promoting a culture of openness, empathy and understanding. This includes talking about mental health openly and without judgement.
  • Providing access to mental health support within school – This includes having a mental health professional, such as a school counsellor, available to provide support to students who are struggling with self-harm. This can include individual counselling, group therapy and referrals/signposting to outside resources.
  • Educating students and parents about self-harm – Educating students and parents about self-harm and providing resources for appropriate support and treatment.
  • Addressing any issues within school which may be impacting on a student’s mental health – This could include issues of bullying or the pressure of workload/exams.

How to support young people who self-harm in the short term

If you’re worried about a child, whether you are a friend, family member or teacher, encouraging them to talk about how they are feeling can be a very helpful first step. Sometimes children are more likely to open up to a trusted adult who is not their parent. This may be because they don’t want to cause their parent to worry, or they may be particularly worried about something that is happening at home, therefore someone who is not as close to the situation may feel easier to talk to.

Always engage with the young person in an empathetic and supportive way; let the young person know that you care about them and that you are there to help them. Reassure them that they are not alone, and that there are people who can help. It is really important for you to remain calm and not blame them for self-harming. This will also help in encouraging them to be honest with you when they have self-harmed.

If a young person opens up to you about how they are feeling, whatever is causing the problem, you should take it seriously, even if it seems trivial to you. Listen to them and respond in a non-judgemental way.

If your child does not want to talk to you, let them know that you are concerned about them and that you are there if they need you. You should encourage them to talk to someone else they trust; this may be another family member, a friend or someone at school. It will be helpful for you to talk to other people who know your child and speak to your child’s school so that they can offer some support. Always let the young person know that you are telling other trusted adults and the reasons why you are doing this. The most important thing is to keep them safe.

Sometimes taking away something a young person is using to self-harm can lead to them finding other ways to hurt themselves and this has the potential to make the self-harming behaviour worse or more dangerous. You could ask your child what would be most helpful for them and ask them to let you know when they feel they want to hurt themselves so that you can support them. If your child feels able to confide in you without feeling like they will get into trouble, they are more likely to tell you when they need help.

It’s important to make sure any injuries or cuts are cleaned and properly looked after. Medical advice is needed immediately for any serious injuries.

Having a list of things that they can do instead when they feel the intense need to self-harm will be helpful.

How to support young people who self-harm in the long term

Focusing on what is causing the young person to self-harm is the most important step. Speaking to your GP and seeking the appropriate support is vital in addressing the underlying cause.

It is important that schools and any other professionals working with the young person are aware so that they can also support them appropriately. Your child’s school may also be able to offer further mental health support through their school-based counsellor.

Finding other, healthier ways for your child to express their feelings may be helpful.

This can include:

  • Writing down how they are feeling/journaling.
  • Punching or screaming into a pillow or anything else that is soft.
  • Exercising.
  • Ripping up paper.
  • Walking or running outside.
  • Talking to friends, family or a counsellor. If talking is difficult they could write you a letter or send a text message – this can sometimes feel less intense for a young person.
  • Listening to loud music.
  • Holding an ice cube in their hand until it melts.
  • Focusing on their breathing and noticing how it feels when they breathe in and out.
  • Painting, drawing, colouring or being creative in another way.

Focusing on what is causing the young person to self-harm is the most important step. Speaking to your GP and seeking the appropriate support is vital in addressing the underlying cause.

Spending time with animals can also be beneficial for children who struggle with their mental health. Animal therapy can help to calm children and allow them to practise regulating their emotions. Children tend to relax and focus because they are gentle with the animals.

Childline offer a helpful tool called a mood journal which young people can use to:

  • Record their mood and how they are feeling.
  • Help them understand if there is any pattern to how they are feeling.
  • Keep track of what helps.
  • Remind them of all the things they are good at and things they should be proud of.

Safety planning is a plan that helps a young person stay safe. A safety plan is a list of coping strategies and sources of support that your child can use before or during a self-harm incident. The young person should be part of the safety planning process and the plan should feel manageable to them. It will be helpful to make a few copies of their safety plan, and it should be easy for them to access. The plan can be on paper or stored on a phone. Make anyone who is working with your child aware of the safety plan and give them a copy.

The safety plan should include:

  • How to stay safe at home.
  • How to stay safe at school.
  • How to keep their environment safe.
  • Their triggers and how to minimise these.
  • Personal warning signs.
  • Things that can distract them when they are feeling the urge to self-harm.
  • Trusted adults they can contact for help.
  • A list of mental health professionals and agencies to call.

Your child’s relationship with you is the most important resource you have. Spending quality time with them, doing a fun activity or something they enjoy and making them feel important and valuable will help build their self-esteem. Many young people who self-harm suffer from low self-esteem.

Self-esteem is about how a young person thinks and feels about themselves. You can help them with this by reminding them of all their good qualities and how proud you are of them. Doing something meaningful that they enjoy can help them to feel good about themselves and to feel like they are achieving something.

Child expressing feelings

Support available

If you are worried about your child’s mental health, you should make an appointment to see your GP. Your GP can refer your child to a local children and young people’s mental health service (CYPMHS) which is able to provide specialist help.

CYPMHS is used as a term for all services that work with children and young people who have difficulties with their mental health or wellbeing. You may also be able to refer your child directly to this service without seeing your GP. Specialist CYPMHS are NHS mental health services that focus on the needs of children and young people.

They are multi-agency teams that often consist of:

  • Psychiatrists.
  • Psychologists.
  • Social workers.
  • Nurses.
  • Occupational therapists.
  • Support workers.
  • Specialist substance misuse workers.
  • Education mental health practitioners – who work in mental health support teams in schools and colleges.
  • Children’s wellbeing practitioners.
  • Primary mental health workers.

Accessing support from a specialist CYPMHS is different depending on where you live, and waiting times can also vary. Most CYPMHS have their own website, which will have information about how to access the service, including phone numbers, so you can get in touch directly to ask for advice.

You may also find it helpful to speak to:

  • Someone at your child’s school.
  • Any other professional who is working with your child.

If you or your child is being supported by social services or the youth offending team, your key worker will also be able to refer your child to CYPMHS.

If you are worried about any aspect of your child’s mental health, you can call the charity Young Minds free parents’ helpline for advice on 0808 802 5544. Their lines are open Monday to Friday from 9.30am until 4pm.

If you are a young person and you feel overwhelmed, or like you want to hurt yourself, support is available for you to talk things through.

To talk with someone confidentially about how you feel, you can:

  • Ring HOPELINEUK on 0800 068 4141.
  • Call the Samaritans on 116 123.
  • Text YM to Young Mind’s Textline on 85258.

If you need help for a mental health crisis or emergency, you should get immediate expert advice and assessment. Here you can find access to an urgent NHS mental health crisis helpline.

If the young person is in danger of immediate harm or their life may be at risk, call 999 or take them to A&E.

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About the author

Claire Vain

Claire Vain

Claire graduated with a degree in Social Work in 2010. She is currently enjoying her career moving in a different direction, working as a professional writer and editor. Outside of work Claire loves to travel, spend time with her family and two dogs and she practices yoga at every opportunity!

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