Supporting a young person struggling with self-harm

Self-harm is when someone hurts themselves on purpose – generally as a way of managing distressing or overwhelming feelings and experiences. Someone who is self-harming might be dealing with lots of intense thoughts and feelings, and hurting themselves may feel like the only way to cope. Others may feel numb and hurt themselves in order to feel something.

Amutha, one of our Trainer Consultants, talks through what self-harm is in this video.

Trigger warning: This video contains mention of self-harm, please take care when watching.

Supporting a young person with self-harm | Trusted adults

Some ways that young people self-harm may include:

cutting themselves
scratching their skin
burning skin
biting skin
hitting themselves, or banging their head or another part of their body against something
pulling hair out from their head, eyebrows or eyelashes
inserting objects into their body
overdosing/self-poisoning
fighting
risky sexual relationships
self-neglect

I was so alone and lost and desperate. I thought no one cared until my youth worker encouraged me to open up. I remember that day so vividly – it was the first day of the rest of my life.

I’m not looking for attention, it’s just the only thing that helps me control the way I feel.

A girl listening to music in the park looking worried.

How to recognise if a young person you know is self-harming

There are many signs you can look out for which indicate a young person is in distress and may be harming themselves, or at risk of self-harm. The most obvious being physical injuries which:

you observe on more than one occasion
appear too neat or ordered to be accidental
do not appear consistent with how the young person says they were sustained

Beyond physical injuries, some other warning signs might include:

secrecy or disappearing at times of high emotion
long or baggy clothing covering arms or legs even in warm weather
increasing isolation or unwillingness to engage
avoiding changing clothes in front of others
absence or lateness
general low mood or irritability
negative self-talk

#NoHarmDone | Responding to Self-Harm | YoungMinds

Starting a conversation about self-harm

You might find yourself in the position of wanting to support a young person who is self-harming. This can be difficult if you are not sure about what to say or do.

Take a look at our video which was co-produced with young people, parents and professionals to reassure those affected by self-harm that things can and do improve.

It was the hardest conversation of my life, but every word I spoke made the load feel a little lighter and for the first time in a long time, I felt hope.

A young person talking to a trusted adult outside on a bench.

The first conversation about self-harm

We know that these conversations are not always easy; but the sooner a young person can be encouraged to talk about how they’re feeling and disclose their self-harm, the sooner it will be possible to provide the right support.

Providing a safe space for a young person to open up is important. If you have a concern about a young person you work with, you should speak to your organisation’s safeguarding lead and, working with them, make a plan for how you can encourage the young person to open up.

Supportive first conversations

The most supportive first conversation is one where:

the young person is the sole focus of your attention
you spend most of your time listening, not talking
the young person tells their story, you never guess or assume
there is a feeling of acceptance and support, not judgement
self-harm is not dismissed as attention-seeking
unrealistic promises are not made about confidentiality
this is recognised as the first step of a difficult journey
clear next steps are identified and followed up promptly
you recognise how hard this conversation must be for the young person
you respond calmly – even if you don’t feel calm

When a young person isn't ready to talk about self-harm

When a young person is reluctant to disclose or discuss their self-harm, three important questions to consider are shown below. If a young person still isn’t ready to open up, provide them with details of anonymous sources of support – such as those listed at the bottom of this page - and regularly check in with how they are.

Who is the best person to have this conversation?

You can use your knowledge of the young person, or ask them who they feel comfortable talking to.
How can you help the conversation flow?

An informal environment or talking while carrying out another activity such as walking or drawing can really help.
Would another medium work better?

Some young people feel happier talking via text or email – be creative and use your knowledge of the young person.

I tried several times to talk to him to no avail; it was only when I texted him that the conversation finally started.

At first, we thought he was just accident-prone, it was easy to miss, and he always had an explanation as to how he’d got hurt.

What to do next

If you have any concerns about a young person's immediate safety, this is an absolute priority and should be treated as an urgent safeguarding issue in line with your organisation’s policies. If you think a young person is at immediate risk, they should not be left alone.

All discussions should be recorded and shared with your safeguarding officer who will keep these details on file and can provide support and direction on appropriate next steps.

Next steps to support might include:

Informing adults who need to know in order to keep the young person safe. This will usually include parents or carers. Invite the young person to consider how they might want to be involved in these conversations.

Supporting the young person to talk to their GP to seek further help and guidance.

Supporting the young person through the next steps of their journey. They may be on long wait-lists or passed between professionals. During this time, continue to ask them how they are and offer the support you are able to provide.

Ensuring wound care. It is important that all wounds are appropriately dressed and cared for as infection is common. Provide the young person with information about wound care or how they can get access to a trained first-aider or medical professional who can assess and dress any wounds.

Tips from adults supporting a young person struggling with self-harm

Make sure you know how to look after yourself after a young person discloses self-harm. You need to process this yourself so you can continue to be there for your young person.
When talking about self-harm, adults can often first focus on the injury, or methodology for harm, but - providing it’s not life-threatening or needs immediate care - focus first on what’s weighing on a young person so heavily that has meant they wanted to hurt themselves.
You don’t need to have the answer straight away. When you go straight into problem-solving mode the young person can end up feeling like they’re the problem.
The things that seem small to you are really big to the young person. Take time to listen.

Supporting vulnerable young people can be emotionally demanding and affect us in ways we don’t anticipate. It is important to create time and opportunities for activities which build our resilience, whether this is a drink with friends or a walk on the beach. We need to look after ourselves in order to support the young people we work with

Helplines where young people can get support

You can share these helplines with the young person you are supporting if they are struggling to open up.

Calm Harm

A free app providing support and strategies to help you resist or manage the urge to self-harm.

Can be downloaded from Google Play or App Store.

Calm Harm
Tellmi

Formerly known as MeeToo. A free app for teenagers (11+) providing resources and a fully-moderated community where you can share your problems, get support and help other people too.

Can be downloaded from Google Play or App Store.

Tellmi
Samaritans

Whatever you're going through, you can contact the Samaritans for support. N.B. This is a listening service and does not offer advice or intervention.

Opening times:

24/7

116123

Samaritans
Childline

If you’re under 19 you can confidentially call, chat online or email about any problem big or small.

Sign up for a free Childline locker (real name or email address not needed) to use their free 1-2-1 counsellor chat and email support service.

Can provide a BSL interpreter if you are deaf or hearing-impaired.

Hosts online message boards where you can share your experiences, have fun and get support from other young people in similar situations.

Opening times:

24/7

0800 11 11

Childline