Self-harm in children and young people

Self-harm is when someone hurts themselves on purpose to deal with difficult or distressing feelings, memories, or situations. 

Some ways young people may physically self-harm include: 

• cutting themselves 

• burning their skin 

• scratching themselves 

• biting themselves 

• hitting themselves or walls 

• pulling hair out from their head, eyebrows, or eyelashes.

However, it’s important to remember that self-harm isn’t always visible. It can also include taking part in risky behaviours, such as: 

• using drugs or alcohol to cope with problems 

• taking part in unsafe sexual behaviour 

• under or over-eating 

• excessive exercising. 

It can be hard to know if your child is self-harming as they may not want anyone else to know.  

If you are worried that your child is self-harming, here are a few signs to keep an eye out for: 

• unexplained cuts, bites, burns bruises, bald patches 

• always keeping themselves fully covered (for example, wearing long sleeves or trousers even during hot weather or avoiding activities such as swimming) 

• feeling depressed, anxious, or angry  

• withdrawing from friends and family 

• low self-esteem, for example, thinking they’re not good enough.

It’s important to remember that someone’s reasons for self-harming will be individual to them.  

It might be difficult to understand from the outside, but self-harm might be a coping technique a young person has learnt to: 

• manage, reduce, or express strong or upsetting emotions 

• relieve tension, or panic 

• experience physical pain to distract from emotional pain 

• to make invisible thoughts and feelings visible 

• gain a sense of being in control  

• stop feeling numb  

• punish themselves for their feelings and experiences. 

After self-harming, some young people may feel relief in the moment. But this feeling is only temporary. The chances are that the root of the problem hasn’t gone away.  

As these challenging feelings grow again, a young person may have more urges to self-harm. Over time, self-harm can bring up difficult emotions.  

After hurting themselves, a young person, may feel ashamed, guilty, or frightened by the fact they are self-harming. They may feel even worse which may lead to more urges to self-harm.  

This can make self-harm a cycle that’s difficult to break - a habit that’s hard to stop.  

Self-harm may be a way to express or cope when something stressful or upsetting is going on in a young person’s life, such as: 

• being bullied 

• struggling with anxiety, depression, or stress 

• confusion about their sexuality or gender 

• low self-esteem or body image issues 

• loneliness 

• grief after a bereavement or loss 

• pressure at school or work 

• family or relationship problems 

• physical, emotional or sexual abuse. 

It’s important to note that although these factors can make someone more likely to self-harm, having any of these experiences doesn’t mean that someone will self-harm. Likewise, someone who self-harms may not have experienced any of these situations. It’s very individual and varies from person to person.  

There are smalls steps you can take to support a child who self-harms. For example, you can:  

Open the conversation and encourage them to get support 

Start the conversation with your child and let them know that they can talk to you any time, for as long as they need.

Understandably you might have lots of questions but remember that your child is going through a tough time, so focus on supporting them emotionally. 

Then ask them how they’d like to be supported and encourage them to seek help. 

Stay calm and don’t judge 

Try to understand their emotions and experiences without judging them or focusing on their self-harm. 

It might be tempting to try to ‘fix’ the situation straightaway, but it may take time. 

Sometimes your child may just want someone to listen to how they are feeling and remind them of their positive qualities.  

Help them to notice when the urge to self-harm started and what’s causing it. 

It can help to think together about how they feel when they want to self-harm.  

What are they thinking about and how do they feel in their body. For example, do they feel stressed and panicky, or do they feel numb and zoned out?  

This can help them to better understand what feelings they’re trying to deal with.  

Find coping techniques to help in the moment 

With time and support, your child will start to understand how they feel when they self-harm and why these urges arise. Then they can learn healthier ways to cope. 

But sometimes, when the urge to self-harm builds up in the moment, it can be strong and persuasive. So, it’s helpful to have a list of things they can do straight away to distract themselves from their intense feelings. 

Not all of these will work for your child – and that’s okay. It varies from person to person and the feelings they’re trying to manage. So, talk to your child about different strategies they could try but give them space to find what works for them.  

Some strategies might include: 

• exercising 

• hitting a cushion 

• shouting and dancing  

• wrapping a blanket around themselves 

• walking in nature 

• listening to soothing sounds 

• breathing deeply and slowly 

• writing lists 

• clenching and relaxing all their muscles 

• holding ice cubes 

• writing down any upsetting thoughts or feelings on a piece of paper and tearing it up 

• do something creative to express how their feeling 

• doing a relaxing hobby they enjoy, such as watching their favourite TV programme or baking. 

Take care of yourself 

Supporting someone who is self-harming can be tough. It may be a long process with lots of ups and downs. For that reason, it’s important to look after yourself. Not only will this help you keep well but it will allow you to better support your child. 

As a safety precaution, it’s worth making sure your child understands first aid and what to do in an emergency if they self harm. 

It's important to take your child to hospital or your GP, if you’re worried about any injuries or wounds or think they require medical attention. Because, without treatment, there may be a risk of infection.  

Reassure your child that they aren’t a burden, and that they shouldn’t be embarrassed or afraid to go to a GP or hospital. Healthcare professionals are there to help them, and should treat them with compassion, dignity, and respect.  

It can help to remember that self-harm is often a coping mechanism to help someone manage difficult emotions.  

Very often, it isn’t an expression of suicidal feelings or an attempt to take their own life. However, people who have experienced suicidal thoughts are more likely to have self-harmed in the past.  

For this reason, self-harm should always be taken seriously. If you're worried your child is struggling with self-harm, it’s important to get treatment as soon as possible to help them better cope with these distressing or overwhelming feelings.  

Remember your family doesn’t have to face this alone. If your child is self-harming, there are different places they can get help. 

Talking together with your GP is a good place to start. They’ll be able to look at your child’s injuries and give them a safe space to talk. They can also direct them to further support, such as Child and Adolescent Mental Health Services (CAMHS) or talking therapies.  

CAMHS are free NHS services that support young people with their mental health. They are sometimes also called CYPMHS (Children and Young People’s Mental Health Services). 

After your GP or school has referred you to CAMHS and CAMHS have accepted this referral, your child will be invited to an assessment. During the assessment, CAMHS will find out more about what they’re going through, so that they can discuss with you what the best support going forward for your child.

Talking therapies  

Your GP may also suggest your child tries talking therapies. This is where they talk to a professional about their thoughts, feelings, and behaviours. There are many different types of therapies. Some of the most popular are counselling or cognitive behaviour therapy (CBT).  

Counselling is where they talk with a trained counsellor about a problem or situation that’s negatively affecting their mental health. Once your child understands how it affects them, they’ll then learn positive coping strategies or ways to improve the situation.  

Cognitive behaviour therapy is a type of talking therapy with a trained therapist. During a session, your child will look at their thinking patterns and behaviour and learn to find new ways of coping when they feel the urge to self-harm.  

It’s natural if your child is feeling anxious talking about self-harm. If they’re worried, remind them that everyone is on their side and are there to help.  

What they tell CAMHS, or their therapist, is confidential, unless they disclose that they or someone else is at risk. So, it’s a safe space where they can get everything off their chest. And your child can always let their healthcare team know if they feel uncomfortable or if things are moving too fast.