Self-harm: advice for parents and carers | Shout 85258

Self-harm is a topic that our texters discuss frequently with us.

In 2021, 24% of conversations with texters under the age of 18 included discussion about self-harm, rising to 28% of conversations with children aged 13 and under.

It is a topic that has been described as a major public health concern, both nationally and globally.

Finding out that a child of yours is self-harming, whether by directly observing the behaviour yourself, someone informing you or by your child confiding in you, might be the first time you have thought about self-harm in any depth.

Because it is a far more common behaviour than is generally appreciated, and because the public often has a narrow view of what self-harming behaviour is, it can be helpful to have some understanding about the issue as well as knowledge about where to go to get further information and to find help - for both yourself and your child.

What is self-harm?

You will find many definitions of self-harm but they generally describe behaviour that is intended to be non-suicidal and that is a coping mechanism.

The University of Oxford's Coping with self-harm: a guide for parents and carers describes self-harm as "behaviour that is done deliberately to harm oneself." The guide provides insight into reasons for self-harming including to:

manage extreme emotional upset
reduce tension
provide a feeling of physical pain to distract from emotional pain
express emotions such as hurt, anger or frustration
as a form of escape
punish oneself or others
gain control over feelings and problems
elicit care from others
identify with a peer group

We know that self-harm is consistent across nationalities and cultures and typically starts between ages 12 and 14, peaking between 15 and 17. However, NICE guidelines for self-harm start at the age of eight, indicating that self-harming behaviours can begin much younger.

While more adolescents think about self-harm ('ideators') than act on their thoughts ('enactors'), most young people will stop using self-harm as a coping strategy. However, the longer people self-harm, the more concerned we become about their mental health trajectory through life. Self-harm is strongly associated with suicide and comorbid (existing simultaneously with) mental health challenges, such as anxiety and/or depression and/or alcohol dependency, so taking action to support someone as early as possible is important.

Myths: what self-harm is not

There are many myths surrounding self-harm, including:

It’s attention seeking and manipulative
Only girls self-harm (in fact, a recent study revealed that twice as many boys aged 5-10 than girls presented to five hospitals in England with self-harm)
It’s part of the youth culture - a fad - and they’ll ‘get over it’
We shouldn’t talk about self-harm

In fact, myths like these can get in the way of taking the situation seriously and taking action - and we should definitely take note and take action.

What should I be aware of?

Self-harm is often hidden but there are behaviour changes that might indicate that your child is struggling and that might prompt you to have a conversation about what you've picked up on and your concerns - self-harm or not. Keep an eye out for changes such as:

withdrawing (from friends and family and activities they previously enjoyed), low mood or acting out
sleeping more or less (although teenagers generally need more sleep, you will more than likely notice changes)
changes in eating patterns
covering up their body more than usual or than is necessary with their clothing, which might indicate they are hiding injuries (for example, long sleeves in warm weather or not wanting to wear sports attire)

Young people themselves have identified triggers that might lead them to self-harm, including:

problems at home or at school
relationship challenges (family, friends)
bullying (including cyber)
media and peer influences
depression and anxiety
low self esteem
transitions and changes in their lives
alcohol and drug use

How to support your child

Finding out your child is self-harming can produce a myriad of emotions including fear, anger, helplessness, shame, grief and disgust.

In the first place, seek support for yourself - both personal and professional - so that you have an opportunity to talk things through and gather information.

Here are some ways you can support your child:

Make time to speak to your child. Focus first on exploring what might be worrying them and avoid judgement. Communication and connection are key to maintaining good mental health and knowing that someone has noticed their struggle can be the first vital step in encouraging a young person to open up and seek and accept the help they might need.
Help you child identify their support system. For a variety of reasons, it is not unusual for young people to avoid speaking to their parents and primary caregivers about their challenges and that they might be using self-harm as a coping strategy. Have a conversation with your child about the circle of trusted adults in their lives who they can trust and speak to - other family members, your friends, neighbours, GP, school counsellor, teachers, student support services
Read the University of Oxford's Coping with self-harm: a guide for parents and carers. The guide has some excellent advice about how to support your child, including: try to deal with self-harm in a matter-of-fact manner; let your child know that their emotions are real and important; remind your child of their strengths and abilities; and explain to your child that you want to help but may not know the best thing to do, and try to come up with a solution together.
Explore Mind’s resources on self-harm. The charity Mind has a wealth of helpful information, support and videos about self-harm for children, young people, families and friends, which includes information on treatment as well as useful contacts for children and young people, such as The Mix and YoungMinds.

If you are a child, young person, parent or carer and want to start a conversation about self-harm, text 'SHOUT' to 85258 any time of the day or night.

If your life is at imminent risk, please call 999 immediately.

If you are a child or young person who needs support with self-harm, you might find our information, advice and resources helpful.