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.
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.
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.
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
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.
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.
Support 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.
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.
A free app providing support and strategies to help you resist or manage the urge to self-harm.
Whether you love the page or think something is missing, we appreciate your feedback. It all helps us to support more young people with their mental health.
Please be aware that this form isn’t a mental health support service. If you or a young person you work with is in crisis right now and wants to talk to someone urgently, find out who to contact on oururgent help page.