Self-harm: when, where and how to seek help

As parents, we’re all too aware that conversations around mental health should be an ordinary part of our daily lives, however tricky the subject. To help, we asked the brilliant children’s mental health charity to give us their advice on how to support a young person who is – or you suspect might be – self-harming, including the signs to look out for and when and where to get help

Rebecca joined Place2Be in 2007, and is responsible for the charity’s work in secondary schools across the UK. Rebecca is a HCPC (Health and Care Professions Council)-registered art psychotherapist and clinical supervisor with more than 20 years’ experience working with children and young people in school settings.

Self-harm is most often used as a coping strategy for dealing with psychological pain. It isn’t attention-seeking, it isn’t a ‘cry for help' or something that can be ‘cured’. By nature, there are many different factors that could lead a young person to self-harm, including (but not at all limited to) bullying, pressure from school, anxiety or depression. In fact, to make it clear, self-harm can affect anyone, of any age, from any background.

It's important to remember that people who self-harm don’t always have suicidal feelings. Instead, the act of self-harm is often a coping mechanism to help them deal with life’s stressors.

The signs to look out for

As a parent/carer, you know your child best. If there are any changes in behaviour that are uncharacteristic, then this is a good indicator that your child may need some form of support. Of course this is not necessarily an indicator of self-harm, but it is always something I’d recommend to be mindful of and curious about. Trust your gut and try to open up a space to support your child.

Below is a starter list of possible signs of self-harming behaviour – again, these are certainly not exhaustive. This list may very well not indicate self-harm at all, but it is worth being aware and vigilant if any of these apply to your child:

Physical injuries (cuts, scratches, burns, bruises… especially on the non-dominant hand or arm)
Blood on clothing or tissues
Reporting frequent ‘accidents’ that cause physical injury
Regularly bandaged arms and/or wrists
Asking for lots of first-aid supplies
Reluctance to take part in physical activity or anything that requires a change of clothes
Covering up arms and legs even when it’s warm
Frequently talking about self-harm, or showing a particular interest in it (e.g. pro-self-harm websites)

What to do if you suspect your child is self-harming

Suspecting or discovering that your child is self-harming can cause an overwhelming array of emotions: panic, guilt, shame, anger, sadness, frustration – all of these are normal reactions.

Remember it’s not your fault and trying to rescue your child by asking them to stop, may not be the best strategy in the immediate moment. Here are a few things you can try if you suspect your child is struggling with self-harm:

Communication is key. Talking about self-harm can be tough for everyone involved. Try to be patient, take your time and try not to push for more information than they are willing to give. The most important thing is to make them feel heard and avoid any language that could be considered lecturing or condescending. You know your child best, so try finding a way of communicating that works for them.

Acknowledge their emotions. You might feel an urgent need to understand why this is happening, but it is best to give your child time and space to talk in a way that they’re comfortable with. You do not need to have the answer. What's more important is to be there with your child and acknowledge what they are feeling.

Focus on the now. It can be really tempting to ask a lot of questions to try and find out as much as you can about your child’s self-harm. However, it is all too easy to slip into interrogation mode. Reliving the self-harming acts may be embarrassing or even traumatic and is not always helpful. Try to focus on the here and now and what would help moving forward.

Explore alternative coping strategies. We know self-harm is often used as a way of trying to manage psychological pain. When talking to your child, try focusing on the feelings that led to the act and help them to explore alternative ways to cope and distract from difficult feelings. Different things will help different people, but examples may include going for a walk, listening to music, deep breathing or even embracing their emotions and having a cry. Distraction is a good technique, and by using alternative coping options and distraction, the length of time between acts of harming may be built up.

Reinforce stability. For children, many aspects of life may feel uncertain, whether it's changes at school, at home or an increased need for independence. The more we create an environment of stability, the easier it may be for your child to navigate challenging emotions. If your child is struggling with their feelings, knowing they have trusted people that they can depend on can be comforting. Remind them you are there for them – no matter what.

Maintain normality. It can be helpful to keep a sense of normality at home, whatever that may look like for you, and this will help your child feel secure and in control. Self-harming behaviours can go hand-in-hand with isolation and can be embarrassing, so it’s most likely they won’t want to be the centre of attention. Carry on as you would while staying aware and supportive.

When and where to get help

Remember, you are never alone when it comes to dealing with your child’s self-harm. Your GP should be your first port of call, but it’s important to communicate with your child’s school as well. In addition, wider assistance is always available – check what’s on offer within your local area, use the dedicated resources listed below and, above all, approach the subject of self-harm with the compassion and warmth you would want yourself when you feel everything is becoming a bit much. It is also essential to note that supporting anyone with self-harm is distressing. Your GP and these services are also there to help you too.

If you are worried about a child or young person, you can contact:

The Parents Helpline, which you can call for free on 0808 802 5544 (9.30am-4pm, Monday-Friday, UK)

Text Helpline, text CONNECT to 85258 to contact Shout for free, 24/7

Although suicidal thoughts and self-harm are not necessarily connected, for some this is the case. I have therefore also included the : free 24-hour telephone support on 116 123

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Self-harm: when, where and how to seek help

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