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Supporting a child who is self-harming

According to NHS figures released today, the number of girls under the age of 18 being treated in hospital in England after self-harming has nearly doubled compared with 20 years ago. Dr Lynne Green, Former Clinical Director at Place2Be offers some advice for parents and professionals.

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Unfortunately the notion that girls who self-harm are little more than attention seeking drama queens who make a mockery of those in ‘real’ distress, lives on. Sadly, this attitude of hostility is not reserved for those who arguably shouldn’t be expected to know about self-harm; it can also be present within mental health professionals themselves.

Don’t get me wrong, as with most things, there are spectrums – degrees of seriousness. The vast majority of young people who self-harm do not have an underlying death wish and indeed find the act of self-harm to be a coping mechanism to help them deal with life’s stressors. For some, self-harm may be a one off experimental behaviour or even an attempt to fit in with the crowd. However, the evidence that those young people who self-harm are much more likely to die by suicide than those who don’t, is undeniably worrying.

So when should we be worried? Whilst we can never be 100% confident of understanding the intent behind self-harming behaviours, we have learned a lot about factors that increase risk.

An increase in the frequency or severity of self-harming behaviours, particularly against a backdrop of other mental health difficulties or complex physical health problems is cause for concern.

Experience of past or current trauma, including bullying is well known to increase feelings of hopelessness and self-loathing which can lead to risk taking behaviours and poor life choices.

Youngsters today arguably face unprecedented challenges within the education system and whilst social media has opened up a whole new world of opportunities, it brings with it an increased sense of vulnerability, plus pressure to conform and present oneself in an unsustainable idealistic way.

How can we help?

Of the many factors known to increase risk amongst those who self-harm, one that sticks out to me is around STABILITY. There are of course numerous contributors to instability within adolescence in particular. School changes, friendship dynamics, increased need for autonomy and independence, hormone changes, challenges within family relationships (including parental separation/conflict), gender confusion – to name but a few. Most are difficult to control so what can we do as parents, carers, health professionals and educators?

The more we can create an environment of stability for our young people, the more we instil a sense of control, a sense of hopefulness, a sense of calm amongst the storm of adolescence. It is crucial our children know that they have trusted people that they can depend on – no matter what.

Talk to your child but above all, listen to them. Children who are not afraid to ask for support when the going gets tough are much more likely to develop resilience in life generally – but they will only ask if they are not scared of the response. Dr Lynne Green, Former Clinical Director at Place2Be

Don’t be afraid to have conversations with your child about their self-harm. Ask them what they find helpful about it – try to avoid a judgemental stance, ‘lecturing’ on the evils of self-harm. Assuming your child is keen to find alternative ways of coping, you can devise a programme together. This could involve identifying triggers to self-harm through ‘real time’ recording, having a plan of alternative activities to use as distraction, removing access to items used for self-harm and crucially, removing access to electronic devices at night time.

Spotting signs early is vital and Place2Be’s early intervention approach within schools is based on this philosophy. Increased withdrawal, deterioration of important relationships, loss of interest in hobbies, tearfulness, sleep difficulties, worsening diet can all be indicators of distress, which coupled with challenging life events and instability can signal concern.

Remember, you are never alone when it comes to dealing with your child’s self-harm. Whether your child is under mental health services or not, advice is at hand – check what is on offer within your local area. Above all, approach the subject of self-harm with the compassion and warmth you would expect yourself in times of distress.

Further reading

Mentally Healthy Schools – self-harm resources


This blog was written in a personal capacity and does not necessarily reflect the view of the organisation.

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