Factsheet 26: Deliberate self-harm in young people: for
parents and teachers
About this factsheet
This is one in a series of factsheets for parents, teachers
and young people entitled Mental Health and Growing Up.
The aims of these factsheets are to provide practical, up-to-date
information about mental health problems (emotional, behavioural
and psychiatric disorders) that can affect children and young
people. This factsheet looks at the reasons behind why some young
people may harm themselves, and offers practical advice about how
to cope with this problem.
Introduction
What is deliberate self harm?
Deliberate self-harm is a term used when someone injures or
harms themselves on purpose. Common examples include `overdosing'
(self-poisoning), hitting, cutting or burning oneself, pulling hair
or picking skin, or self-strangulation. It can also include taking
illegal drugs and excessive amounts of alcohol. Self-harm is always
a sign of something being seriously wrong.
Why do young people harm themselves?
Self-injury is a way of dealing with very difficult feelings
that build up inside. People say different things about why they do
it:
- Some say that they have been feeling desperate about a problem
and don't know where to turn for help. They feel trapped and
helpless. Self-injury helps them to feel more in control.
- Some people talk of feelings of anger or tension that get
bottled up inside, until they feel like exploding. Self-injury
helps to relieve the tension that they feel.
- Feelings of guilt or shame may also become unbearable.
Self-harm is way of punishing oneself.
- Some people try to cope with very upsetting experiences, such
as trauma or abuse, by convincing themselves that the upsetting
event(s) never happened. These people sometimes suffer from
feelings of `numbness' or `deadness'. They say that they feel
detached from the world and their bodies, and that self-injury is a
way of feeling more connected and alive.
Who is at risk?
Self-harm is most commonly triggered by an argument with a
parent or close friend. When family life involves a lot of abuse,
neglect or rejection, people are more likely to harm themselves.
Young people who are depressed, or have an eating disorder, are at
greater risk. So are people who take illegal drugs or excessive
amounts of alcohol.
Where can I get help?
Anyone who is harming themselves is struggling to cope and
needs help. Self-injury is often kept secret - even from friends or
family. The person feels so ashamed, guilty or bad that they can't
face talking about it. There may be clues, such as refusing to wear
short sleeves or to take off clothing for sports.
If you are a parent or teacher, you can help by:
- recognising signs of distress, and finding some way of talking
with the young person about how they are feeling
- listening to their worries and problems, and taking them
seriously
- offering sympathy and understanding
- helping with solving problems
- staying calm and in control of your feelings.
- being clear about the risks of self-harm - making sure they
know that, with help, it will be possible to stop once the
underlying problems have been sorted out
- making sure that they get the right kind of help as soon as
possible.
It's important to make sure that the young person feels that
they have someone they can talk to and get support from when they
need it. Otherwise, there is a risk they will harm themselves
instead. It's important to ask whether parents and family will be
able to give the support that's needed. This may be difficult if
there are a lot of problems or arguments at home. As a parent, you
may be too upset or angry to be able to give the help that is
needed. If so, you should seek advice from your general
practitioner.
If you are a teacher, it is important to encourage students to
let you know if one of their group is in trouble, upset or shows
signs of harming themselves. Friends often worry about betraying a
confidence and you may need to explain that self-harm can endanger
their lives. For this reason, it should never be kept secret.
Specialist help
If you feel that more professional help is needed, the general
practitioner should be able to tell you what help is available
locally, and make a referral to your local child and adolescent
mental health service.
The aim is to discover the causes of the problems. It is usual
for parents or carers to be involved in treatment. This makes it
easier to understand the background to what has happened, and to
work out what sort of help is needed.
There are different talking approaches, depending on what is
causing the problem. Treatment often involves both individual and
family work. Individuals will need help with how to cope with the
very difficult feelings that cause self-harm. Families often need
help in working out how to make sure that the dangerous behaviour
doesn't happen again, and how to give the support that is needed.
If depression or anxiety is part of the problem, these will need
treating (see
Factsheet 34 on depression in
children and young people). Occasionally, intensive help may be
needed. Sometimes, recovery from very damaging or traumatic
experiences happens slowly. Then specialist help is needed over a
longer period of time.
References
- Carr, A. (ed.) (2000) 'What Works with Children and
Adolescents?' - A Critical Review of Psychological Interventions
with Children, Adolescents and their Families. London:
Brunner-Routledge.
- Rutter, M. & Taylor, E. (eds) (2002) 'Child and
Adolescent Psychiatry' (4th edn). London: Blackwell.
- Scott, A., Shaw, M. & Joughin, C. (eds) (2001) 'Finding
the Evidence' - A Gateway to the Literature in Child and Adolescent
Mental Health (2nd edn). London: Gaskell.
Sources of further information
- National Self-Harm Network: PO Box 7264, Nottingham NG1 6WJ;
e-mail: info@nshn.co.uk;
www.nshn.co.uk.
- The Young People and Self Harm information resource website:
www.selfharm.org.uk.
- Childline provides a free and confidential telephone service
for children. Helpline: 0800 1111; www.childline.org.uk.
- The Samaritans provide a 24-hour service offering confidential
emotional support to anyone who is in crisis. Helpline 08457 909090
(UK), 1850 609090 (ROI); e-mail: jo@samaritans.org website:
www.samaritans.org.uk.
- YoungMinds provides information and advice on child mental
health issues. 102-108 Clerkenwell Road, London EC1M 5SA. Parents'
Information Service 0800 018 2138; www.youngminds.org.uk.
- A CD-ROM designed for 13_17 year-olds on mental health which
looks at depression and self-harm: 'Changing Minds' A
Multimedia CD-ROM about Mental Health. Further details from
the Royal College of Psychiatrists: tel. 020 7235 2351, ext.146;
www.rcpsych.ac.uk/publications/auvideo/cmindscd/index.htm.
- Or you may like to look at these
websites:
- www.lifesigns.ukf.net
- www.nshn.co.uk
- www.selfharmalliance.org
- www.nhsdirect.nhs.uk
- The Mental Health and Growing Up series contains 36
factsheets on a range of common mental health problems. To order
the pack, contact Book Sales at the Royal College of Psychiatrists,
17 Belgrave Square, London SW1X 8PG; tel. 020 7235 2351, ext. 146;
fax 020 7245 1231; e-mail: booksales@rcpsych.ac.uk, or
you can download them from this website.
© [2004] Royal College of
Psychiatrists. This factsheet may be downloaded, printed out,
photocopied and distributed free of charge as long as the Royal
College of Psychiatrists is properly credited and no profit is
gained from its use. Permission to reproduce it in any other way
must be obtained from the Head
of Publications. The College does not allow reposting of its
factsheets on other sites, but allows them to be linked to
directly.
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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