Self-harm in teenagers

Realising that your child is self-harming can come as a shock. Why would they want to hurt themselves? It can help to start by learning what self-harm is and understanding the common reasons for it. Then, you can consider practical first steps for supporting your child or another young person who is self-harming.

This can help if you:

• know or suspect that your child is self-harming

• want to learn more about self-harm

• want to be able to recognise the signs of self-harm

• need more information about what to do if your child is self-harming.

What is self-harm?

Self-harm (or self-injury) is when someone deliberately harms their body but without suicidal intent. It can be done by cutting or by other means. You may not understand it, or why your child might be doing it, and it will probably be very confronting. It’s really important for you to learn more about self-harming and support your child by identifying the cause of the behaviour and helping them to develop more effective coping skills for self-harm.

For most young people who self-harm, it’s a way to cope with or gain relief from painful or difficult emotions, thoughts or memories. It’s not a direct attempt to end their life. However, people who self-harm may be at a greater risk of accidentally causing potentially life-threatening injuries.

For some young people, self-harm may be happening alongside having suicidal thoughts and there may be more going on with them than just the physical behaviour.

Why do young people self-harm?

Self-harm in teenagers is usually a reaction to emotional stress. Research shows that around one in three young people have considered harming themselves, and in the past decade young people have consistently had the highest hospitalisation rates for self-harm.

Issues that can cause self-harm in teenagers

While every situation is different, there are common immediate causes stemming from a wide range of issues that people may not be directly aware of or associate with the self-harming behaviour. These can include:

• bullying in or out of school

• stress and depression

• a troubled family life

• lifestyle factors such as housing insecurity or financial stress

• relationship issues or breakdowns

• study or performance stress

• childhood trauma or abuse

• mental health problems.

The response to any or all of these issues won’t always be for a teenager to self-harm. Whether your teen reacts to these issues by self-harming may depend on if they have alternative ways of coping with stressors and how overwhelmed they feel by their situation. It can be difficult to understand why your child has resorted to self-harming behaviour, and it’s important to listen to them and try to understand rather than judge them.

Young people's common reasons for self-harming

Some reasons that young people have put forward to explain their self-harming behaviour include:

• trying to express strong, complicated or hidden feelings

• proving to themselves that they aren’t invisible

• feeling in control

• getting an immediate sense of relief

• communicating a need for support.

If your teen is self-harming as a way to communicate that they need support, it’s important not to imply that it’s attention-seeking behaviour. Attaching negative judgements to a self-harming situation may isolate your teen and prevent them from seeking health or emotional support from you in the future.

For more advice on how to approach this topic, read our guide to having difficult conversations with your teen.

The signs of self-harm in teenagers

It can often be hard to spot the signs of self-harm in teens as many young people will try to keep them hidden. Sometimes you’ll notice unexplained injuries, but more often the signs are changes in normal behaviour.

Social and behavioural signs of self-harm may include:

• wearing long-sleeved clothes in hot weather

• avoiding swimming or other activities where a lot of their body can be seen

• hiding clothes or washing them separately

• being secretive about their room or possessions

• creating strange excuses for injuries

• changing their eating, sleeping or communication habits

• being less active socially or less interested in school and hobbies.

Emotional and physical signs of self-harm may include:

• having frequent injuries or sores

• being less energetic or appearing pallid

• often feeling sick and unwell

• feeling sad, angry or irritable

• appearing disconnected or disinterested during conversations

• putting less effort into their hygiene or appearance

• feeling guilty or ashamed.

Because the self-harming behaviour is often hidden, the signs may not be obvious. This is why it’s important to be alert to any indications that your child may be thinking about self-harming or has already self-harmed.

What to do if your child is self-harming

Communicate with them calmly about your concerns

The first step in supporting your child should be to speak to them calmly and without judging them or becoming angry. Let them know that you’re here for them, and allow them to share with you why they feel the need to self-harm. Listening intently will show your child that you care, and will help them to feel that you understand their emotions and needs.

It may not be easy to bring up the subject of self-harming. Your teenager may be resistant to speaking about it, or may become emotional or ‘switch off’ from the conversation. If they are hesitant to talk with you about it, encourage them to speak with another family member or a support person they feel they can trust, such as their school counsellor.

Try approaching the conversation from a supportive place, rather than shaming or condemning their actions.

Affirm to your child that:

• they aren’t in trouble

• you aren’t angry with them or ashamed of them

• your intention is to help and support them to heal

• you understand, or are looking to understand, how they feel

• you’re willing to listen to them without judging them.

After listening to your child and offering them emotional support, it’s important to take practical steps. A good place to start is to support them in removing any items they may use for self-harm purposes and in seeking medical care for any injuries.

Seek professional self-harm support

The next step is to connect your teen with professional help from a GP or a mental health service. Speaking with a professional will help them to recognise why they are self-harming and to learn new skills and behaviours for managing their urge to self-harm.

Your teen may not want to engage with a professional health service, out of shame or fear, and approaching them about this may be tough. You can support them through these feelings by preparing them for the experience of talking to a professional, as well as by sharing with them other stories of young people seeking professional help, which may minimise their fear or shame.

Once you connect your child with professional help, you should continue to support them by encouraging their coping strategies, assisting them in seeking ongoing professional care, and checking in on them through open and caring conversations.

Self-harm in teenagers and suicide

Although self-harm or self-injury is action without suicidal intent, people who self-harm may be at a greater risk of accidentally causing potentially life-threatening injuries, or they may also be experiencing suicidal ideation.

While it may feel confronting to do so, asking your child directly whether they are having suicidal thoughts allows them to open up to you and to seek support. If your teen expresses suicidal ideation or intention, you can support them in accessing crisis support and ongoing professional support and by creating a suicide safety plan.

Crisis or emergency support for self-harm

You may find yourself in a situation where you need to access emergency or crisis support. In those instances, it’s best to approach the situation as calmly as possible, ensuring that you don’t convey anger or fear to your child. Provide first aid and seek additional medical care when necessary.

Witnessing your child self-harming can be very confronting. It’s important that, in addition to seeking support for your child, you also look after yourself.

Ways to look after after yourself when your teen is self-harming

By looking after yourself, you’ll be in a better position to offer non-judgemental support to your child and to guide them through seeking care.

Looking after yourself may look like:

• speaking with a health-care professional such as your GP or a counsellor

• practising self-care, such as exercising, journaling or meditating

• reaching out to your community for support

• connecting with other parents in similar situations on the ReachOut Parents Forum

• accessing one-on-one support through ReachOut Parents Coaching.

Keep in mind that whichever support option you pursue, it’s important to maintain your child’s privacy and not share their confidential medical information.

Find more ways to try to help your child with self-harm.

Some commonly asked questions about self-harm in teenagers

What self-harm treatments are available to my teenager?

Therapies such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), among others, focus on helping your teen find healthier ways to cope with what they’re experiencing. These and other treatments and medications may address causes for the distress they’re feeling. Sometimes people who self-harm have underlying mental health concerns which are contributing to the self-harm. Treating the underlying concerns can reduce self-harming.

What are common ways young people self-harm?

Teens might self-harm in different ways. You might notice behaviour or signs of cutting, scratching, or hitting themselves. Some teens may pull out their hair, burn their skin or pick at wounds. While this can be distressing, it’s important to understand that this is often helping them to deal with intense emotions. Recognising the signs can help you better understand what’s going on for them and seek support.

What should I do if my teenager has suicidal ideation?

If your teen is having suicidal thoughts, reach out to them with love and listen without judgement. Seek professional help right away and provide information about services like Lifeline, that they can access immediately. Read more in this guide about what to do if you think your teen is suicidal.