Self-harm

Self-harm is any deliberate, non-suicidal behaviour that inflicts physical harm on the body and is aimed at relieving emotional distress. Self-harm is a coping mechanism. An individual harms their physical self to deal with emotional pain, or to break feelings of numbness by arousing sensation.

Childline's Review 2012/2013, "Can I Tell You Something?", stated that during the year Childline counselled 22,532 young people whose main concern was self-harm. This represented a 41% year-on-year increase.

In Shropshire the latest figure of children and young people for self-harm inpatient admissions was 93 admissions in 2011/2012, this is high when looked at as an average rate against national figures.

Shropshire's Safeguarding Children's Board has developed a Self-Harm Pathway which includes guidance and tools for practitioners working with young people who are self-harming.

Why do children and young people self-harm?

Factors that motivate people to self-harm include a desire to escape an unbearable situation or intolerable emotional pain, to reduce tension, to express hostility, to induce guilt or to increase caring from others.

A young person may self-harm because they are suffering depression, have a psychiatric disorder, have low self-esteem, have a difficult family life, are suffering from abuse or neglect, have difficulty in forming relationships or because they are isolated or being bullied. There may be many other reasons why a young person chooses to self-harm and it is usually the symptom of an underlying problem.

Examples of self-harming behaviour:

  • Cutting;
  • Taking an overdose of tablets;
  • Swallowing hazardous materials or substances;
  • Burning, either physically or chemically;
  • Over/under medicating, e.g. misuse of insulin;
  • Punching/hitting/bruising;
  • Hair-pulling/skin picking/head-banging;
  • Episodes of alcohol/drug abuse or over/under eating, at times may be deliberate acts of self-harm;
  • Risky sexual behaviour.

How to spot the signs

The young person's behaviour and emotional well-being may have changed. They may suffer mood swings and become withdrawn. Other signs to be aware of may include:

  • Changes in eating/sleeping habits;
  • Increased isolation from friends/family;
  • Low self-esteem or an increase in negative self-talk;
  • Frequent injuries (i.e. cuts, bruises, burns) with suspicious explanations;
  • Covering up their body (even in warm weather);
  • The presence of behaviours that often accompany self-injury: eating disorders, drugs/alcohol misuse, excessive risk taking;
  • Discovery of tools used for self-injury (broken disposable razors, lighters, un-bent paper clips).

What to do if you know someone is self-harming

If you know that a child or young person is self-harming initially acknowledge the courage it has taken for them to seek help and acknowledge the self-harm. Discuss with them the limits of your confidentially and explain why it is necessary for you to share information in order to keep them safe.

  • Keep calm and give reassurance;
  • Follow first aid guidelines;
  • Maintain the young person's trust and involve them in decisions;
  • Inform the designated person for child protection in your agency;
  • Discuss concerns with the young person's parents, unless to do so would place the young person at further risk;
  • You will need to complete the Self-harm Reporting Form on page 14 of the SSCB Self-Harm Pathway Guidance. Refer to the Care Pathway on page 21 of the SSCB Self-harm Pathway Guidance for further guidance on next steps.

For further information, advice and guidance for practitioners please refer to the SSCB Self-harm Pathway.

Resources

Local publications

Local sources of information

Refer to the SSCB Self-harm Pathway Guidance for details of local support services.

National Advice and Help Lines

  • Childline
    24hrs helpline for children and young people under 18 providing confidential counselling
    Tel: 0800 1111
  • PAPYRUS
    Offers a helpline to give support, practical advice and information to anyone who is concerned that a young person may be suicidal
    HOPELineUK: 08000684141
  • Bristol Crisis Service for Women (national support available)
    Supports women and girls in emotional distress, especially those who self-harm, or their friends or relatives
    Limited opening hours: 0117 925 1119
  • National Self-harm Network
    Support for people who self-harm, provides free information pack to service users.
  • Samaritans
    Confidential, emotional support for anybody who is in crisis.
    Tel: 08457 90 90 90
  • Young Minds
    Information on a range of subjects relevant to young people.
  • Young Minds Parents Information Service
    Tel: 0808 802 5544
  • The Mix
    Support service for young people under 25.