What is self-harm?

Self-harm is when someone intentionally sets out to harm themselves. This may be an impulsive act or may be planned.

Young people self-harm in different ways with the most common methods being:

  • Cutting and scratching
  • Self-poisoning
  • Burning
  • Hitting or punching oneself
  • Head banging and hair pulling
  • Engaging in risky behaviour

Around half of young people who self-harm will harm themselves more than once.

Thoughts of self-harm

  • Thoughts of self-harm are common. Community surveys show that approximately 1 in 4 young people will have thoughts of self-harm over the course of a year.
  • Of those who report thoughts of self-harm LESS THAN HALF will act on them and go on to harm themselves.
  • Suicidal ideation where the young person expresses a GENUINE desire to die is rare.
  • Thoughts of hopelessness such as “I wish I was dead” are common. It is therefore important to explore the meaning behind the words the young person says.

Acts of self-harm

  • Around 1 in 10 young people aged 12-17 will harm themselves.
  • Cutting and overdose are the commonest methods
  • Girls are twice as likely as boys to self-harm
  • We know little about self-harm in children. In adolescents self-harm increases from the age of 12
  • Few acts of self-harm result in attendance at A&E with most remaining private and hidden.

Young People and Suicide

Fortunately, suicide in young people under the age of 18 is rare. However:

  • Although rates are probably under-reported, in the UK, around 180-200 young people die by suicide each year.
  • Children as young as 11 have died by suicide.
  • Suicide rates increase with age and are higher in late teens.
  • Boys are more than twice as likely to die by suicide as girls.
  • Approximately half of those who die are not known to any agency or service.

Who is at risk of self-harm and suicide?

A number of factors have been found to be associated with self-harm and suicide. These include:

  • Being female (self-harm) and male (suicide)
  • Depression and low self-esteem
  • Past abuse or trauma
  • Gender orientation problems
  • Drug and alcohol misuse
  • Poor parental mental health
  • Previous experience of suicide or self-harm
  • Interpersonal difficulties and bullying
  • Family problems

Why do young people self-harm?

Young people do not self-harm as a way of seeking attention. This is a myth. The three most common reasons why young people self-harm are:

  • Tension relief – a number of young people are unable to deal with their unpleasant feelings and use self-harm as a way of relieving stress and tension.
  • Self-punishment – young people who self-harm often have low self-esteem and feel that they are worthless or bad people who should be punished.
  • To express distress – for some young people, self-harm is a way of showing others how bad they are feeling. They may use this as a way of reaching out to get help.

What might trigger self-harm?

Self-harm can be triggered by lots of different things that might create stress or unhappiness. These could include:

  • Friendship issues
  • Feeling alone
  • Bullying
  • Arguments with family
  • Stress and worry about school work
  • Feeling unhappy with yourself
  • Feeling worthless

How should I react if a young person self-harms?

  • Stay calm and don’t panic
  • Let the young person know that you are concerned about them
  • Make sure they are physically OK. If they have taken an overdose talk with their GP or go with them to the A&E Department
  • Don’t be judgemental or say it was 'silly'
  • Don’t ask them to promise not to self harm – this is unrealistic and makes it less likely that they will talk to you or anyone else again
  • Talk about what happened and what triggered this
  • They may be embarrassed or ashamed of what they did so be patient.
  • The section on SLEEP can help you talk about self-harm and plan what help the young person needs.