Talking about Self-harm

Talking with young people about self-harm is not always easy. It is a difficult thing to talk about and many people worry that if they talk about self-harm they might make things worse.

There is NO EVIDENCE to suggest that talking about self-harm will encourage young people to harm themselves. In fact feedback from young people is that they want to talk. However this needs to be done sensitively since our responses can sometimes be seen as uncaring.

Sometimes a young person may talk to you about their self-harm but ask you not to tell anyone else. DO NOT promise to keep this a secret. You need to decide who needs to know in order to keep that young person safe.

SLEEP is an acronym to help you remember 5 important steps when talking with young people about self-harm.

  Stop

  Listen

  Empathise

  Explore what they are saying

  Plan what you will do

Sleep

Stop and make time to talk

Remember that if a young person approaches you it is you that they want to talk with.

The young person may not find it easy to talk so they need to be given time. Don’t try to have a rushed conversation.

If you are in the middle of doing something or are busy then let the young person know that you will make a time to talk with them. Make a time there and then so that they know you are taking them seriously.

Give the young person your undivided attention. Show them that they are important and that you care.

Make sure that where you meet is private so that you can have an open and honest conversation without interruptions.


sLeep

Listen to what the young person is saying

Listen carefully to what the young person is saying. Listening signals that you care and will encourage them to talk.

They may feel embarrassed or ashamed of what they have done so be patient and give them time.

You don’t have to jump in and try and fix things. Just listen to what the young person is saying.


slEep

Empathise with how they are feeling

Young people need to know that you understand how they are feeling.

DO NOT be judgemental or shocked by what they say. This will signal that it is not OK to talk about these things and they may be less open.

Empathise with how they are feeling. Acknowledge that they are feeling distressed and that they must be feeling really bad.

Reassure them that things can change. They have made an important step by talking with you today.


sleEp

Explore what the young person is saying

Be curious and explore what the young person is really saying

Young people might say that “they wish they were dead”. These words are frightening but they do not necessarily mean that the young person is suicidal.

Often young people say these things because they are feeling hopeless or frustrated and don’t know what to do. Check this out and explore what the young person means.

The harmLESS questions provide a way of exploring this.


sleeP

Plan what you will do

The final stage is to agree the next steps. In the majority of situations this can be agreed collaboratively with the young person.

You need to decide who you need to talk with in order to keep the young person safe. A young person may not always want their parents or carers to know, but if they are at risk of seriously hurting themselves their parents need to know.

Tell the young person that you are concerned about their safety. Because you are worried about them you need to tell people so that they can help the young person to keep safe.

The harmLESS questions can help you plan what response is needed.


Next Steps

A range of options are available:

  • First Step: A further meeting to review and monitor their self-harming thoughts or behaviours. Acknowledging and talking about how they are feeling can be helpful. By arranging a further meeting you send a clear signal that you care
  • Support: To discuss what they have spoken about with others who might already be involved. There may be a counsellor, social worker, or somebody else involved who can help the young person.
  • CYPS referral: If the self-harming is longstanding and regular or there are clear suicidal plans, contact:
  • NHS 2gether Children and Young People Service (CYPS) Practitioner Advice Line

    Telephone: 01452 894272

    Opening times: Monday-Friday 9am-5pm excluding Bank Holidays

    or

    2gether Crisis Team

    Telephone: 0800 1690398

    Opening times: Out of hours emergency only (age 11+)