Talking to your teen about self-harm behaviours like cutting can be very challenging. We suggest starting with a calm, compassionate conversation. Express your concern without judgment and ask open-ended questions to understand their feelings. You might say, “I’m worried about you and noticed these marks. Can you tell me what’s going on?”
Self-harm is when a person deliberately hurts and/or damages their body as a way of dealing with very difficult feelings, painful memories or overwhelming situations and experiences. It is an expression of emotional distress. Self-harm is a serious mental health concern for young people.
The majority of self-poisoning episodes involve prescribed or over-the-counter medication, and a minority involve illicit drugs, other household substances, or plant material.
The majority of self-injury episodes involve cutting.
Self-harm includes suicide attempts as well as acts where little or no suicidal intent is involved (for example, where people harm themselves to reduce internal tension, communicate distress, or obtain relief from an otherwise overwhelming situation).
Signs to look out for can include:
- covering up, for example by wearing long sleeves a lot of the time, especially in summer
- unexplained bruises, cuts, burns or bite-marks on their body
- blood stains on clothing, or finding tissues with blood in their room
- becoming withdrawn and spending a lot of time alone in their room
- avoiding friends and family and being at home
- feeling down, low self-esteem or blaming themselves for things
- outbursts of anger, or risky behaviour like drinking or taking drugs.
Helpful questions to ask to assess self-harm
- Suicidal ideation. Even though self-harm isn’t usually about suicide, some people think about suicide when they self-harm. Research has shown that using self-harm as way to avoid suicide is actually one of the strongest risk factors for attempting suicide, and a history of self-harm is a predictor of future attempts. It is important to ask Did you mean to end your life?
- Onset, frequency, and methods. Gather information about your child’s first and most recent self-harm behaviours, as well as frequency and methods (e.g., cutting, biting, blood loss.)
- Learn whether/how your child cares for their self-harm wounds.
- A self care Kit can look like this ;cloth and gauze to stop any bleeding,
- Alcohol free wipes to clean the wound,
- Wound closure strips,
- Large adhesive dressings,
- Low adherent dressings for covering the wound,
- Micropore tape,
- and a bandage to keep the dressing in place and clean
- What prompts you to harm yourself? Young people may self-harm to try to relieve stress, punish themselves, counteract feeling numb, and more.
- Stage of change. Learn about your child’s motivation to change or stop their self-harm. e.g What is happening when you have self-harmed/what causes you to act on your thoughts?
- When was the last time you self-harmed?
It goes without saying that all of these questions should not be asked at once, do your research and prepare yourself to ask the difficult questions and make sure you have support in place too , you are the expert on your child.
Acknowledge that self-harm is a way to cope with distress and gently discuss healthier alternatives Microsoft Word – Coping mechanisms for self harm-client’s.docx It can be helpful to say I didn’t know how upset you were, how can we face this together? Encourage open communication and let them know you’re there to support them. Involving a mental health professional is crucial, you can make a referral here Make a Referral | Exchange Counselling If you’re concerned about their immediate safety, take them to an A&E or use one of these resources available 24/7:
– Papyrus 0800 068 4141
– Self Injury support 08088008088 text 07537432444
– Calm 0800 585 858
Learn more here
Exchange Resource | Exchange Counselling
Self-Harm Video Resources | The Chelsea Psychology Clinic
Self-harm | Advice for young people | Get help | YoungMinds
How to support someone who is self-harming – Samaritans
NSPCC – Understanding child self-harm
