What is self-harm?
Self-harm involves intentionally causing injury to oneself, often as a manifestation of psychological distress. It is commonly triggered by an acute stressor or interpersonal conflict, and is also referred to as self-injurious behaviour or deliberate self-harm. It can take many forms, including medication overdose, poisoning, cutting, headbanging or burning.
Why does a child self-harm?
For most young people, self-harm is a response to strong emotions — often felt in extremes, such as intense anger or sadness. The physical act can provide a form of release, offering some respite from overwhelming feelings that feel impossible to manage in other ways.
Self-harm is a complex behaviour pattern that emerges when a child struggles to regulate their emotions in other ways. The pattern can become cyclical, with negative thoughts and behaviours reinforcing one another. With the right support, this cycle can be broken.
How common is self-harm?
Current data is likely to underestimate community rates of self-harm, but the prevalence among children and adolescents has increased significantly in recent years. Data from the Office for National Statistics shows that rates of non-suicidal self-harm have risen across the whole population over the past two decades.
When should you seek specialist help?
Self-harm can follow a specific pattern, but it can also evolve and become more severe over time. Specialist help should be sought as early as possible. Early intervention is key to preventing the behaviour from becoming entrenched, and to addressing any underlying social, psychological or interpersonal difficulties the child may be experiencing.
Who should you refer to?
Contact your child's GP, or speak to the Special Educational Needs Co-ordinator (SENCO) or school nurse. If there are acute concerns about a child's safety or wellbeing, they should attend the emergency department for specialist assessment by the child and adolescent mental health team.
What support is available?
Treatment options focus primarily on helping the child regulate their emotions in a more controlled way. This can involve psychoeducation, talking therapy, identifying unhelpful thought patterns or stressors, and — in some cases — treatment of an underlying mental illness through medication, psychological intervention or social support.
Practical strategies can also help a child manage the impulse to self-harm in the moment:
Distraction — something personal to the child, whether drawing, watching a favourite film or taking a relaxing bath.
Exercise — a walk outside or a sports activity can help to shift the focus away from difficult emotions.
Talking to someone — a child may find it helpful to speak with a trusted person about how they are feeling, whether a teacher, parent or friend.
Spending time with others — if a child doesn't feel ready to talk, simply being around someone they trust can help.
Writing in a journal — some children find it easier to write their feelings down, particularly if expressing emotions verbally is difficult.
Controlled breathing — focusing on slow, steady breathing can help to reduce the intensity of difficult emotions. Encourage the child to breathe in a calm, controlled way with minimal distractions.
