The term ‘self-harm’ is used to describe behaviours where a person intentionally injures or causes harm to themselves; these behaviours may include self-injury (such as cutting, bruising or burning) or self-poisoning (such as taking too many tablets). The reasons why a young person engages in self-harming behaviours are individual to them, and in some instances, the young person may not know the reasons themselves. Self-harm is common, with approximately one in twelve young people engaging in self-harming behaviours in the United Kingdom (Young Minds, 2021). Self-harm is often described as a way of coping with or expressing emotional distress or overwhelming built-up tension.
Emotional Distress and self-harm
Self-harming behaviours may be used as a way of responding to or coping with overwhelming emotional distress (NHS, 2021). This built up emotion may be due to difficulties at home or school or due to individual factors such as low-self esteem and struggles with anxiety.
Self-Harm and Suicide
In some instances, young people who engage in self-harming behaviours may also have suicidal thoughts and intentions. This is not the case for every young person who self-harms but there is an increased risk for suicide in 10-24-year olds who have previously self-harmed (Forward Thinking Birmingham, 2020). It is important that a dialogue is started with the young person to ensure they receive appropriate support for them.
It can be difficult to recognise when a young person has started to self-harm as they may take steps to ensure their peers do not notice. If you suspect a young person is engaging in self-harming behaviours, here are some warning signs to look out for:
If you suspect a young person is self-harming, and are concerned about their immediate safety, follow your school’s safeguarding policies and ensure your concerns are passed onto a Designated Safeguarding Lead (DSL) immediately.
How to help
Whilst we are preparing ourselves to help others we must also look after ourselves, we’ve got some advice and guidance on this in the teacher wellbeing section. As with all matters of mental health, taking time to gain awareness of self-harm and suicidehelps to build confidence in what we do and how to support early intervention and prevention.
Self-harming behaviours and suicidal intentions are serious and will require appropriate professional support. As teaching professionals, it is important to remain alert to the signs that a young person is distressed, intentionally causing harm to themselves, or in some instances, thinking about suicide. Repeated self-harm is common following the first instance;listening to the young person and providing them with a safe, non-judgemental space to talk is the first step in helping them to access appropriate support to help break the cycle.
When taking steps to support a young person who may be self-harming, remember to be CLEAR (Forward Thinking Birmingham, 2020):
Check for self-harm (or suicidal thoughts and intentions) – let them know you are concerned about them and ask them directly if they are having any thoughts about suicide. If yes – check whether they have made any plans and do not leave the young person alone.
Listen to their story – It is important to listen to a young person non-judgmentally, give them time to communicate how they feel and let you know what’s been going on for them.
Empathise and inform – reassure them that they do not have to cope with this alone – that you are there to help and to get them the right support.
Apply self-help techniques – ask about their support network and if there is not an immediate crisis – help them make a plan of what has helped in the past and what could help now. Make sure you are also able to show or share the information we have provided about online support and telephone helplines on our website.
Refer to a health professional – If a young person is in crisis or in immediate danger then it is vital that they see a health professional; this might mean calling the police using the 999 number or arranging an accompanied emergency visit to their GP.
The first conversation
When approaching the topic of self-harm with a young person, it is important to do so sensitively and without judgement; providing a safe space where the young person can disclose and openly talk is first step in providing them with the support they need.
Supportive conversations should:
Put the young person at the heart of the conversation, ensure they are your sole focus
Focus on what the young person has to say
Be honest: ensure the young person knows your limits around confidentiality
Making assumptions or saying the young person is attention seeking
Making the young person feel ashamed
Threatening dialogue: this may include giving the young person a detention as a result of their self-harming or threatening to take away breaktimes or separate them from peers if they continue what they are doing
For more information on how to approach the topic of self-harm with young people, please see the ‘Having the first conversation’ booklet published by Young Minds.
Supporting those not ready to talk
When approaching the topic of emotional regulationor self-harm, you may find the young person is hesitant to discuss how they are feeling or reluctant to disclose their self-harm. Consider if there is another person who may be better placed to have this conversation, such as the young person’s form tutor, or ask the young person if there is an adult which they feel more comfortable talking to.
Remember that they may want to talk but may not feel comfortable or ready; try talking to the young person whilst engaging in another activity, such as painting, drawing or playing a sport, and consider whether any other mediums can be used to facilitate a conversation, such as sending an email or writing a note.
Next Steps Following a Disclosure
Speak to your school’s Designated Safeguarding Lead (DSL) immediately; they will ask you to record details of your conversation with the young person and may ask you to be involved in supporting the young person whilst they are at school. If you are asked to provide further support, such as arranging frequent meetings with your person, ensure you are comfortable to do so and let the DSL know if you have any concerns at the earliest opportunity.
For further information on how to support a young person following a disclosure and for information on practical strategies to support young people, please see the ‘No Harm Done: Recognising and responding to self-harm’by Young Minds.