Self-harm

Self-harm is when a child intentionally damages or hurts their body. It can become addictive because of the natural pain-relieving endorphins that are released when people hurt themselves, which can give a temporary sense of relief.

Each child’s relationship with self-harm is complex and different. It often happens during times of anger, distress, fear, anxiety, loss or depression.

It can also be a coping strategy for:

  • dealing with difficult situations
  • changing emotional pain into physical pain
  • communicating distress about something in a non-verbal way
  • attempts to relieve feelings of numbness, anger or aggression

Self-harming and risky behaviours can also be a way for a child to punish themselves for feelings or behaviour that they think are their fault, or because they have a very negative self-image.

Spotting the signs

Self-harm can include:

  • self-cutting
  • burning
  • scratching
  • biting
  • hair pulling
  • head banging

Risky behaviour

Risky behaviour can sometimes be a form of self-harm, although it is often misinterpreted or overlooked. All children will take risks and learning how to manage them is an important part of development. But when risk-taking is persistent, extreme, age inappropriate, or compromises a child’s safety and wellbeing, it can be a way of communicating distress, or highlighting that a child is struggling, or using risk-taking to lift their mood or distract/punish themselves in some way.

Risky behaviour can take many forms including:

  • persistently challenging behaviour
  • truancy
  • online risky behaviour such as sharing personal information, developing online (and offline) relationships with strangers; playing games rated for much older children; mixing with older peers or involvement in potentially abusive relationships
  • eating disorders
  • sexualised behaviour
  • taking other risks that compromise physical safety or excessive sensation seeking
  • taking illegal drugs or excessive amounts of alcohol
  • attempted suicide

Some risk-taking and sensation-seeking may be a sign of other underlying needs such as attention deficit hyperactivity disorder, behaviour problems or speech and communication needs.

Find out more about self-harming and risky behaviour

MindEd is a free educational e-learning resource for professionals on children and young people’s mental health. The following session aims to help staff better understand children’s self-harming behaviours.

  • Self-harm and risky behaviour: provides the background to self-harm in children and teenagers, common associated conditions and approaches to managing it.

Top Tips

If a child is self-harming, say something.

Doing nothing is the worst thing you can do – talking about it won’t encourage more self-harm. Although you’ll want to tell a child to stop self-harming, it can be just as useful to show concern for them in the first instance.

Listen.

It may take a few invitations to talk before a child feels able to risk sharing with you, but the most important thing you can do is listen. 

Talk.

When the child is ready, make a plan and discuss and agree it with them. This might include setting aside another time to listen. Action what you’ve agreed and keep the child informed; explain if you don’t manage to do something.

What schools can do

Thoughts can really influence and affect our emotions and moods. However, many children may not be aware when this is happening to them. Some will become overwhelmed by thoughts and emotions. 

A number of universal and targeted school-based programmes and PSHE resources can prevent children being overwhelmed by thoughts and emotions helping them learn effective coping skills to express their feelings, develop coping skills and manage life’s ups and downs. These programmes also help children connect with, label and express emotions in a healthy way which is an important protective factor. 

Positive relationships in the classroom/school that are built on trust, safety and security promote pupil wellbeing and help children feeling overwhelmed by thoughts or emotions – encouraging them to open up and talk. 

Some children will also need a little extra help either through school pastoral/counselling support, through discussion with your school nurse or through referral to community-based support.

Concerned about a child?

If you are worried that a child is at risk involve your designated safeguarding lead as a matter of priority who will contact the parents/carers and other services as necessary. If the child is at immediate risk, ensure that they are taken to their GP or A&E as a matter of urgency, depending on the severity of the concern.

Find out more

Resources

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Identify and support children who are self-harming

Identify and support children who are self-harming

Webpage to help parents and professionals identify and support children who may be self-harming.

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How schools can support children who self-harm

Guidance for schools on supporting children who self-harm.

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  • Ealing Council and London Healthy Schools

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Managing urges to self-harm

Practical resources for children and young people to help them manage overwhelming emotions and...

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Supporting mental health and wellbeing in schools

Supporting mental health and wellbeing in schools

The Anna Freud National Centre for Children and Families has produced a booklet for primary and...

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Self-harm: coping strategies

Examples of effective coping mechanisms that can help a child who is self-harming. It also provides...

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Self-harm: having the first conversation

Self-harm: having the first conversation

Download this resource to learn how to encourage young people to talk to someone about their...

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No harm done: recognising and responding to self-harm

No harm done: recognising and responding to self-harm

It can be difficult to know how to support a young person who is self-harming. Here's a simple guide...

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Shout Crisis Textline

Shout Crisis Textline

If you’re experiencing a personal crisis, are unable to cope and need support, text "Shout" to 85258...

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