Coping with self harm

Guidance for parents and carers

Self-harm is behaviour that is done deliberately to harm oneself. Varying from one young person to another, it can include: self-cutting, taking an overdose, hitting or bruising, intentionally taking too little or too much medication, burning, hanging or suffocation.

At least 10% of adolescents report having self-harmed in some way.

Although some young people who self-harm may be suicidal, self-harm is often used as a way of managing difficult emotions. However, self-harming can result in accidental death.

This guide has been developed from conversations with parents and carers of young people experiencing difficult times. It is aimed at helping parents, carers, other family members and friends cope when a young person is self-harming.

If you would find it helpful to have this information in a booklet, you can download it as a pdf or order a hard copy.

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Signs a young person is self-harming

As a parent or carer, you might suspect that your child is self-harming. Changes in behaviour or physical signs may have indicated this to you, even if you have not spoken with your child about it yet.

If you are worried, watch out for these signs:

  • Unexplained cuts, burns or bruises
  • Keeping themselves covered; avoiding swimming or being reluctant to change clothes around others
  • Being withdrawn or isolated from friends or family
  • Low mood, a lack of interest in life or depression
  • Blaming themselves for problems or expressing feelings of failure, uselessness, hopelessness or anger.

Finding out about self-harm

Discovering that your child is self-harming can be very upsetting and stressful.

Some children may tell their parents about their self-harm; other parents might find out from friends, teachers or medical staff.

A range of emotions may be experienced by parents.

These include anger, sadness, helplessness, shame or disgust.

It is perfectly normal to feel strong emotions. It’s important to try and understand and accept them so that you don’t risk misdirecting these emotions towards your vulnerable child.

Try to reframe their behaviour and think of it as an expression of deep emotions they can’t handle any other way.

“We worked out that if she sent me a blank text, I knew she needed some company or a cuddle or some distraction.” 

HealthTalk.org parent interview

Teen girl holding phone

Reasons for self-harm

Self-harm can serve several different functions, from reducing tension to providing a form of escape. As a parent or carer, it helps to understand why your child may be self-harming - and to be aware of possible future problems.

Self-harm can serve a number of different functions, which vary from person to person. Self-harm can be used as a way to:

  • Manage extreme emotional upset 
  • Reduce feelings of tension
  • Provide a distraction from emotional pain through experiencing physical pain 
  • Express emotions such as hurt, anger or frustration
  • Temporarily escape from current difficulties
  • Attempt to regain control over feelings or problems
  • Punish themselves or others
  • Elicit care from others
  • Identify and bond with a peer group
  • Attempt suicide

What makes a young person vulnerable?

At least 10% of adolescents report having self-harmed in some way. Young people may experience challenges during their formative years, and a number of factors can make them especially vulnerable to self-harm.

The early and teenage years can be both challenging and isolating for young people. Individual factors which increase the vulnerability to self-harm can include: depression, anxiety, low-self-esteem, hopelessness, poor problem-solving, impulsivity, eating disorders, drug or alcohol abuse and bullying (e.g. because of race, sexuality or other issues).

Family life can make a substantial difference to a young person’s mental wellbeing. Family factors which increase the vulnerability to self-harm can include: mental health difficulties in the family, poor parental relationships, drug/alcohol misuse in the family, unreasonable expectations, conflict between the young person and parents, excessive punishments or restrictions and a family history of self-harm, abuse or neglect.

The social setting and environment that a young person occupies can have a strong influence on their well-being. Social factors which can make a young person more vulnerable to self-harm include: difficulties in peer relationships, bullying, peer rejection, abuse, availability of methods of self-harm, friends who self-harm and media and internet influences.

Self-harm can be a serious problem - and repeated self-harm is common following a first episode. Depending on the method, self-harm has the potential to lead to serious physical damage, such as permanent scarring and the medical effects of a dangerous overdose. Self-harm may be linked to other problems including: depression, anxiety eating disorders or drug and alcohol use, for which specific treatment may be required. Individuals who have self-harmed are at higher risk of suicide than other young people, although the risk is still low.

Managing injuries from self-harm

If your child has self-harmed and you are concerned about their physical wellbeing (e.g., a wound that is too deep to manage at home or other serious injuries; they have taken an overdose) you should seek emergency medical help through your local Accident and Emergency service. There are a number of practical steps that you can take as a parent or carer to protect your child if they have harmed themselves.

  • Get your child to an A&E department as soon as possible
  • Try to find out what they have taken in advance, if you can, and tell medical staff upon arrival
  • If your child won’t tell you, look around for empty pill bottles or blister packs. This will help medical staff to give your child the most appropriate care possible.

  • Apply pressure to bleeding cuts using a bandage or towel (a tea towel may be less likely to stick to the wound)
  • Clean the wound under running tap water and apply a sterile adhesive dressing
  • If the wound has become infected (for example: swelling, pus forming or spreading redness), encourage your child to seek medical help as soon as possible.

  • Cool with cold water for 10 to 30 minutes, then cover with cling film
  • Don’t use ice or any creams or greasy substances such as butter
  • For more information on handling wounds and burns, and when to see a doctor, visit the NHS website or ring NHS Direct on 111.

  • If your child has scars they are embarrassed about, you can look into commercial products that may help them fade
  • Scars can also be covered up by makeup
  • Remind and reassure your child that most scars will eventually fade with time.

What parents and carers can do to help a child who self-harms

If you are a parent or carer of a child who self-harms, it is only natural that you will feel deeply concerned and worried about your child's wellbeing. Yet there are practical and positive ways in which you can support your child through these times.

Make time for an open conversation with your child. Try to talk about wider topics and shared interests rather than immediately confronting the big issue that you want to discuss.

A change of setting from the family home can lead to a more honest discussion. Look to spend time together in an environment where you both feel comfortable.

It’s important to ask open questions rather than ‘yes/no’ questions and let your child lead the course of the conversation. It may be that you need to have a few talks together before you can raise the subject of self-harm.

This is an opportunity to reassure your child and be there for them. Make it clear that you are not being judgemental or putting them down; your child always needs to know that you love them and that this will not change.

A listening ear from a caring adult can give a vulnerable child the opportunity to express their concerns in a positive and cathartic way. Try to avoid asking too many questions or interjecting; let your child speak about what is troubling them.

Self-harm is not an easy topic to speak about, for parent or child. If your child does not want to talk with you about it, that’s perfectly understandable and normal. Instead, ask if they will write you a note, email or text message describing how they feel.

Your child may prefer to open up to another trusted adult instead of you. It may be easier for them to openly share their feelings with someone outside of your family. If this is the case, arrange an appointment with your GP or recommend a counsellor or helpline. 

If your child is able to open up with you about their self-harm, see if you can help them work out feelings and situations that may be triggering it. You may need to also seek advice and expert support from a trained counsellor or mental health professional, but it is helpful if you can personally understand the key drivers that lie behind the self-harming.

Through open conversation, try and work together with your child to think of ways to handle and deal with strong feelings. There are many alternatives to suggest that don’t involve self-harm.

Seeing the situation from your child’s perspective is important, as is helping your child to find possible solutions. Explore their problems together and look for more positive ways to resolve these.

It can be all too easy to fall into catastrophic thought patterns, especially as a vulnerable young person. The guidance of a caring adult can be calming and reassuring. By listening and showing empathy, help your child to see that things may change for the better in the future.

Tips for helping your child if they are self-harming

Self-harm is often used as a way of managing difficult emotions. For a vulnerable young person that is self-harming, it is important to know that they are not alone.

Some people who self-harm may be suicidal. If your child speaks to you about suicide, confront the issue in a non-judgemental way and discuss this openly together.

Your child is going through a very difficult time, but try to look around and beyond the self-harm through conversation and activities that bring you closer together.

Let your child be upfront and open with you, and don’t shy away from the situation. Discuss the facts of the self-harm together, without judgement.

Your son or daughter needs to be heard and understood. Their feelings are valid and you need to explore these together.

All children appreciate reassurance about their personal abilities. This is especially true for vulnerable young people. Remind your child about their unique strengths.

Whatever their difficulties, make it clear to your child that you support them and love them unconditionally.

It’s good, to be honest with your child about your level of knowledge and understanding as a parent. Try to come up with a solution together to seek further help: either visiting the GP or speaking with a counsellor or helpline.

If your child is receptive to the idea, you can explore ways to make it harder for them to access the tools needed to self-harm (for example, storing medication securely or removing sharp objects). This must be a decision that is reached together.

If your child is unable to explain to you what is triggering the self-harm, lookout for signs that might be leading to this - these could be social or individual factors.

Attending to your own needs

It is normal for parents to experience strong emotions when coming to terms with a child’s self-harming. This is a difficult and unsettling time and it is important that you look after yourself as well as your child.

Be mindful of your own body and watchful for physical signs of stress, such as stomach aches, difficulty sleeping or depression.

Take time for yourself when you are upset and working through challenging emotions. Be intentional and do things that you enjoy, such as going out with friends, regular exercise, reading or practicing hobbies. Look for positive distractions to focus your mind and energies elsewhere.

Identify the emotions that you are experiencing and be honest with yourself. It may help to write these down in a journal or notebook. Find an outlet for your emotions, such as talking to a trusted friend, relative or therapist.

You may also find other emotions coming out as anger - this is natural and understandable, but be careful that your child does not think this is directed at them.

Give yourself permission to relax and take time out for yourself: only do things that really need doing and don’t worry about less important tasks. Take time off work if you are able, and accept help from family and friends.

While looking after yourself, keep having conversations with your child in the most comfortable way for you both. Your child may remember what you say even if they don’t seem to be listening at the time, and may take your advice and talk to you later.

Trying to help your child may sometimes be very frustrating. However, when they push you away is often when they need you the most. Remember, most young people who self-harm will stop sooner or later.

When to seek further help

Self-harm can be a serious problem and may be linked to other problems such as depression, anxiety, eating disorders or drug and alcohol use. If you are worried about your child’s health and wellbeing, you should seek further help. Support and guidance is available to you at this difficult time.

Visit your GP

Your general practitioner (GP) may be able provide medical guidance and advice to manage the self-harm. The GP may also refer your child to a community Child and Adolescent Mental Health Services (CAMHS) where an assessment would be done and a plan made for support and treatment. Professional help is also available from school nurses and trained counsellors and therapists.

If your child is reluctant to get help, you can still receive advice from your GP. It may be the case that your child doesn’t acknowledge the risks or is unwilling to speak with a GP. If so, you can still make an appointment for yourself to discuss the situation with a medical professional. It is best to be transparent and do this with your child’s permission.

Admission to hospital

If your child goes to hospital for any reason related to their self-harm, they should be seen by someone who will talk to them about self-harm, assess their mental wellbeing and arrange follow-up where needed. If it is not clear whether this has happened, ask the staff about it. 

Possible future problems

Self-harm can be a serious problem and repeated self-harm is common following a first episode. Depending on the method, self-harm can lead to serious physical damage, including permanent scarring, the medical effects of a dangerous overdose, etc. Self-harm may be linked to other problems, such as depression, anxiety, eating disorders or drug and alcohol use, for which specific treatment may be required. Individuals who have self-harmed are at higher risk of suicide than other young people, although the risk is still low. For these reasons, it is important where possible to tack self-harming behaviour early.