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Deliberate self harm - advice for parents and carers

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Deliberate self harm involves the purposeful harming of one’s body to cope with distressing or intolerable feelings and thoughts. Harm is usually done by cutting or scratching the body or non-lethal drug overdoses. It can also include other high risk behaviours intended to cause the self harm. Approximately 10 -20% of young people engage in self harm, and often without ever disclosing this to others.

Self harm is behaviour with different functions, depending on the individual, such as:

- To reduce overwhelming feelings such as sadness, fear, or shame
- To ‘feel’ something where there is an absence of emotion or a numbness
- To reduce tension or anxiety
- To act as an avoidance of emotions, by focusing on bodily pain
Signs and symptoms

There are sometimes signs that a young person is self harming, but often this behaviour is concealed from others and not disclosed, so can be difficult to recognise. The signs below could indicate self-harm, but are also signs of general distress for a young person.

  • Withdrawal from everyday life.
  • Signs of depression such as low mood, lacking in motivation
  • Changes in mood, such as increased anxiety
  • Expression of suicidal thoughts, or talk about self-harm
  • Expression of feelings of hopelessness
  • Changes in eating/sleeping habits.
  • Risk taking behaviour (substance misuse, unprotected sexual acts, promiscuity), deliberately neglecting or not managing health condition (e.g. skipping insulin injections, taking too much medication).
  • Unexplained cuts, bruises or marks.
  • Covering up all the time, even in warm weather.
  • Lacking energy.
How to help

If you suspect someone you know is self-harming, there are some things that you can do to help:

  • Take time to have a conversation with the young person, where they feel safe and able to open up to you.
  • Encourage them to talk to you, or if not, someone else they trust.
  • Approach the topic sensitively and non-judgmentally. Young people will often feel shame about their self harming behaviour, may have complex reasons for self harming, may lack other means of coping, and may feel afraid of what might happen if others find out
  • Don’t force them to tell you the details of self harming behaviour, instead ask generally how they are feeling, what they have been thinking, and how they are coping.
  • Reassure them that there are things that can be done to support them, such as seeking advice from your GP, or dial 111 for more immediate advice.
  • Be aware of the limits of your involvement. If a child or young person is expressing suicidal thoughts, or is in imminent danger of harm, be clear that you will need to seek help to make sure they are safe.
Useful resources

Young Minds

Whether you are a young person wanting to understand more about how you're feeling and find ways to feel better, or you want to support someone who's struggling, Young Minds can help.

Breathing Space

Breathing Space aims to provide:

  • an alternative and easily accessible ‘first stop’ service
    assistance at an early stage in order to stop problems escalating
  • empathy, understanding and advice through active listening
  • hope when none exists
  • direction for those who do not know where to seek help

So don't let problems get out of hand, phone Breathing Space, where experienced advisors will listen and offer information and advice. Tel: 0800 83 85 87

Calm Harm

Calm Harm is an award-winning app developed for teenage mental health charity stem4 by Dr Nihara Krause, Consultant Clinical Psychologist.

Calm Harm provides tasks to help you resist or manage the urge to self-harm.


SafeSpot is an app designed to help young people improve their coping skills.

As well as links to download the app, the website contains games and resources to support mental health.

Editorial Information

Last reviewed: 18 January 2022

Next review: 31 March 2025

Author(s): Paediatric Psychology Service