Parents and carers – I am worried a family member or child in my care

What is Self-Harm?

There are a lot of different interpretations of self-harm, but put most simply, it most often describes when someone causes harm to themselves in order to cope with thoughts, feelings or difficult circumstances. Often this takes the form of direct self-harm where the sufferer physically hurts themselves in some way such as cutting, burning or scratching themselves, other times it may take the form of indirect self-harm where a young person does themselves harm through actions such as risk-taking or neglect of themselves.

Whilst the ways in which a young person might do themselves harm are unlimited, there are some ways we tend to see more commonly. Amongst children up to about 12 (or older for those young people with special needs) we most commonly see:

• Scratching and rubbing
• Picking at the skin or not allowing wounds to heal
• Pulling out of hair – anywhere on the body, commonly head hair or eyelashes
• Biting, including biting lips and severe nail biting
• Banging and bruising including head banging and e.g. throwing oneself down stairs 

During adolescence and beyond, the most common forms or self-harm we tend to see are:

• Cutting
• Burning
• Non-lethal overdoses
• Consuming poisonous substances
• Physical and sexual risk taking
• ‘Punching stuff up’ or repeated fighting
• Embedding items in the skin
• Depriving oneself of sleep or food
• Self-neglect including poor wound management

If we consider self-harm in its broadest sense then we might also consider misuse of alcohol or drugs or eating disorders to be forms of self-harm.

As you can see, there are a wide range of ways that young people might harm themselves. The thing that all of these actions have in common is that they are a means of coping, so self-harm is essentaially an unhealthy coping mechanism and any behaviour that can be considered to be an unhealthy way of coping with thoughts, feelings or difficult circumstances might be considered under the umbrella of self-harm.

What warning signs should I look out for?

There are several signs that you can look out for that might indicate that your child is self-harming or is at increased risk of self-harming. It can be helpful to be alert to these, though remember that as their parent you are probably very well attuned to their typical mood and responses to events. If you feel that things aren’t right, even if you don’t have any specific evidence to draw on, then it’s important to talk to your child or to find another means to support. Warning signs include:

• Unexplained injuries
• Secretive behaviour
• Long or baggy clothing and a reluctance to change in front of others
• Lateness or absence from school
• Increasing social isolation
• More withdrawn or irritable personality
• Low self-esteem and feelings of failure 

My child is self-harming – what next?

Finding out that your child is self-harming is likely to feel very distressing, and many parents feel unsure what to do next and find themselves struggling with a huge mix of emotions ranging from guilt, to anger, to distress and hopelessness. These are all quite normal reactions and it’s important that you give yourself the space and time you need to process your thoughts and feelings and that you consider your own wellbeing as well as that of your child.

As a parent or carer, the most helpful things you can do to help your child are to:

• Ensure they are physically safe and receive any medical attention needed
• Make time to listen to your child, or identify someone else they can talk to
• Explore practical ways you can help your child manage each day
• Support your child in accessing further support or treatment