Dealing with self-harm
There is widespread concern about the emotional wellbeing, and
the proportion, of young people who self-harm today. This page is
designed to help you understand why some young people may self-harm
and how Samaritans can help.
Useful self-harm resources to
help young people, parents, families and education
professionals were assessed in our Step by Step project.
1. What is self-harm?
Self-harm involves injury or
harm with a non-fatal outcome as a way of coping with unbearable
feelings. Cutting, burning and poisoning are usually
considered to be self-harm. Some people also include eating
disorders, all substance abuse and self-neglect as
self-harm.
Many different labels may be
used for self-harm. Some of these include: self-harm,
self-injury, self-poisoning, deliberate self-harm (DSH),
non-suicidal self-injury, parasuicide, intentional self-harm,
self-mutilation, attempted suicide, suicide gesture.
The labels of “deliberate”
and “intentional” may be patronising for people who self-harm
because they do not reflect the lack of control that people
experience when they feel the need to self-harm.
2. Why do young people
self-harm?
Young people who self-harm
describe it as a way of getting relief from and coping with
unbearable feelings. Feelings of loneliness and wanting
to punish themselves are common.
Sometimes people who
self-harm are portrayed as attention-seeking – this is rare, and if
this is the reason for self-harming it is likely that the person
feels very strongly that important emotional needs are not being
met.
Many different things may
lead to someone self-harming. The following factors increase
the risk of young people self-harming:
- Not having a strong support network
- Not being able to get help from teachers or family
- Being in care
- Being lesbian, gay or bisexual
- Being a survivor of sexual abuse
More young women self-harm
than young men. When young men self-harm, they are likely to
have more medically serious injuries or poisoning than young
girls.
Depression is common among
young people who self-harm, but not everyone who self-harms has
mental health problems.
Researchers have estimated
that between 20,000 and 30,000 young people in the UK each year
need hospital treatment following self-harm. Surveys suggest that
much larger numbers of young people self-harm without getting
hospital treatment, with perhaps only 1 in 8 self-harm occurrences
leading to hospital treatment.
3. How is self-harm linked to
suicide?
Most people who self-harm do
not harm themselves with the intention of dying. Some people
explain that self-harm gives them a way of staying alive by coping
with overwhelming feelings.
However, there are strong
links between self-harm and suicide. Suicide risk is
considerably higher among people who self-harm (especially if they
attended hospital for treatment after self-harm) than in the
general population. Many people who die by suicide have
self-harmed or attempted suicide previously. Due to the risk
of future suicide, self-harm is a focus of suicide reduction work.
But there are gaps in understanding about the links between
suicide and self-harm and we cannot say that self-harm causes
suicide.
4. How many people
self-harm?
It is very difficult to
answer this question. As people who self-harm are emotionally
distressed, information must be collected with great sensitivity
and many people would be unwilling or unable to share this very
personal information.
There isn’t a system for
accurately collecting information about hospital treatment
following self-harm for the whole of the UK. However,
researchers have estimated that between 20,000 and 30,000 young
people in the UK attend hospital each year after self-harming.
A recent large survey in
England showed that among 16-24 year olds, 1 in 6 women (17%) and 1
in 13 men (7.9%) reported that they had ever self-harmed. This
information was collected by asking people to write their own
responses. In the same survey, fewer people said that they had
self-harmed when they were asked by an interviewer face to
face.
Similar surveys among 15-17
year olds found that 1 in 10 reported having ever self-harmed in
Northern Ireland; 1 in 7 in Scotland and 1 in 8 in the Republic of
Ireland.
5. What helps people who
self-harm?
Young people who self-harm
say that feeling listened to and accepted are very important to
them.
If someone has told you that
they self-harm, you may feel several different emotions and you may
be unsure how to respond. It is important to keep
communicating with them in a positive way, letting them know that
you would like to understand. It may be tempting to try to
‘take over’ or to persuade them to stop self-harming but it is
really important to let them make the choices. In general, it
is best to focus on their feelings (while letting them choose what
to tell you) rather than on the physical harm. Factsheets
with further guidance are available at:
When someone who self-harms
chooses to access professional help, there are a range of
treatments and therapies that may be helpful. It is clear
that there is no ‘one size fits all’ and not all treatment will be
effective for everyone so it is important that a person who
self-harms finds the most appropriate treatment for their
needs.
The National Institute for
Clinical Excellence (NICE) emphasises that when people who
self-harm access medical treatment, they should be treated with the
same care, respect and privacy as any patient. These guidelines
also recommend that people attending hospital after self-harming
should be offered psychological assessment and appropriate
follow-on treatment.
6. How can Samaritans
help?
Samaritans offers a range of
services to assist those affected by self-harm.
- Anyone experiencing
emotional distress or despair is welcome to contact Samaritans for
support, including people who self-harm or who are
affected by supporting someone else who self-harms.
Samaritans can be contacted by
Phone: 08457 90 90 90 (UK), 1850 60 90 90 (ROI)
Email: jo@samaritans.org
Letter:
Chris, P.O. Box 90 90, Stirling FK8 2SA
Face to face: We have 201 branches in the UK and ROI so find
your nearest local branch.
- Samaritans’
DEAL programme for 14-16 year olds. DEAL (Developing
Emotional Awareness and Learning) provides this age group with the
skills and information to develop positive coping strategies to
deal with difficult life situations. The programme includes lesson
plans on self-harm and other topics, factsheets and supporting DVDs
in which young people talk about their emotional health and
self-harm. Further details are
available in our DEAL introduction.
- Samaritans’
professional trainers deliver work-based training for groups of
staff who come into contact with people who
self-harm. This day course helps to improve skills and
confidence when working with people who self-harm and is delivered
at the clients’ workplace.Find out more
about our course Working with People Who Self-harm.
7. Where can I find out more
about self-harm?
Useful self-harm resources to help young
people, parents, families and education professionals were
assessed in our Step by Step
project.
You may find it useful to
visit the websites of the following organisations: