A parent’s guide to self-harm and self-injury in young people

 By Anna Smyth, psychologist

Self-harm and self-injury can be a single act or a repeated behaviour. Either way, it’s serious, dangerous and can end in suicide. Early intervention is critical. There are signs to look for and many ways to get help for your child.

What is self-harm and self-injury?

Self-harm or self-injury is any behaviour that is deliberate and causes pain to the person doing it. Self-harm can look different for different people and can involve using your body or tools like knives, scissors or medication. Often it could be cutting, hitting, burning or scratching the skin. Some people abuse substances like drugs or alcohol. Others put themselves in dangerous situations on purpose.

Self-harm is most often used to try to stop or manage emotional or psychological pain and distress. While dangerous, it’s a coping mechanism and the physical feelings might temporarily relieve emotional pain. A person might not aim to die when they self-harm, however, there is always a risk of accidental death. It is common in people who are struggling with depression.

Who is at risk of self-harm and self-injury?

Anyone is at risk of self-harm or self-injury, but it’s most common in young people. Studies have found 1 in 10 Australian adolescents have self-harmed. Research suggests that the average age for self-harm to first occur is between 12-14 years’ old. It is more common in girls than boys – 22.8% of 16–17-year-olds have self-harmed.

Studies by Beyond Blue found that adolescents who are part of the LGBTIQ+ community were more likely to be psychologically distressed than non-LGBTIQ+ people. Another study found 33% of the LGBTIQ+ community have self-harmed, particularly transgender people. In fact, 4 out of 5 young transgender people had self-harmed, with 1 in 2 attempting suicide.

The COVID-19 pandemic has seen an increase in psychological distress and the use of mental health services. Studies found that 1 in 10 Australian adolescents have self-harmed at some stage and 23% of 16–17-year-old women had self-harmed.

What are the signs my child is self-harming?

Children and young people usually self-harm in secret as they feel ashamed and embarrassed about what they are doing. It may be hard to spot. But there are often tell-tale signs, including scars or scabs; unexplained cuts, scratches or bruises; and wearing long clothes in hot weather that cover the skin.

Keep an eye-out for sharp objects like knives, razors and bottle caps. Is your child spending a lot of time alone in their room or the bathroom? Other signs might be unstable and impulsive behaviour or comments about feeling worthless or hopeless. Less common things are pulling out hair, strange behaviour around eating, and hitting walls.

What are the causes of self-harm and self-injury?

The most common causes of self-harm and self-injury are feelings of emotional distress. Children and young people self-harm to find relief and cope with their feelings. Some self-harm due to loneliness, while others feel they are punishing themselves as they feel shame and guilt. Most often, people self-harm because they can’t see any other way to feel better.

For some, self-harming can be a cry for help when they can’t use their words to communicate. Self-harm can be seen in people experiencing depressive symptoms or clinical depressive disorders such as major depressive disorder, bipolar disorder or persistent depressive disorder (also called dysthymia). There may be social triggers, such as bullying, school or work problems, or conflict with family, friends or romantic partners.

How is self-harm and self-injury treated?

Treatment for self-harm and self-injury often looks at the root cause of the behaviour. It might be depression or anxiety, or both. Treatment can be guided by a psychologist or therapist who might use cognitive behavioural therapy (CBT) or dialectical behaviour therapy (DBT).

CBT helps people identify negative thought patterns and unhelpful behaviours, then changes them. Coping strategies for difficult emotions and problem-solving will be worked on, so the person doesn’t feel like they have to hurt themself.

DBT is similar, however, it also teaches mindfulness techniques and ways people can cope with uncomfortable emotions (including the deep dive technique which is explained in a moment).

Social support is essential and can be found through family, friends, peer groups, school counsellors and mentors.

How can I help my child? (Including the ‘deep dive’ technique)

It can be hard for young people to stop self-harming on their own, which is why it’s critical to seek professional help. In the meantime, there are things you can do. Replacing self-harm with things that are less harmful can be helpful for your child, such as getting them to hold ice cubes. This can cause feelings of pain yet it’s something safe for them to do.

Using a ‘deep dive’ technique can be helpful. Fill a bowl with icy cold water. Get your child to hold their breath and put their face in the water for 30 seconds. Deep dive is often used to provide immediate calmness as it starts our parasympathetic nervous system (our soothing system). Deep breathing and meditation exercises or punching a punching bag are other options.

How can I get support?

Early intervention is the key to manage self-harm, suicidal behaviour and depression in children and young people. If you or your child’s teacher notices signs of self-harm or depression, book an appointment with your GP or pediatrician to discuss options. Both will help you find a suitable psychologist or mental health professional. There are also Medicare rebates for up to 20 mental health services from a psychologist each calendar year. Ask your GP for a referral.

If you feel that your child is suicidal or in danger, you can contact a 24-hour crisis support line like Lifeline Australia (13 11 14) or Kids Helpline (1800 55 1800). You can also call 000 or go straight to your nearest hospital’s emergency department.

While self-harm is scary and serious, it is important not to judge your child, give ultimatums or panic. Instead, remain calm and focus on supporting them helping them to find safe ways to cope, and listening to them so they feel heard and supported.

You may also benefit from talking to a psychologist at Spencer Health. Many of our psychologists specialise in children and young people. Contact us for more information or to book an appointment.

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