Self-harm
Self-harm occurs when people intentionally hurt themselves, without intending suicide (although self-harm can result in death). Self-harm can result from a range of harmful behaviours, but the most common form of self-harm for teenagers is cutting. Often self-harming behaviour will be hidden from others, which can make it incredibly difficult to assess. The reasons for self-harm are not clearly understood, and may differ from person to person. Given the extremely serious nature of self-harm, and the potential for serious physical danger, it is crucial that those at risk of self-harming receive psychological support as early as possible.
Signs this might be a problem:
social withdrawal, loss of interest spending time with friends and engaging in other recreational activities
physical injuries, such as cuts or scratches on the body, or scars that look to be from past self inflicted injuries
continual attempts of the person to hide or cover up a part of their body, which may be at attempt to cover up self injury.
What is self-harming?
Self-harm refers to when a person deliberately injures themselves without intending suicide (although in serious instances death may occur). The most common form of self-harm is cutting, but other forms of self-harm may include deliberate poisoning and overdose, burning or swallowing sharp objects likely to cause internal damage. Self-harm is an extremely serious issue affecting young Australians and is most likely to occur or begin during the teenage years. Many young people do not tell anyone about their self-harming, so it is hard to know exactly how many people self-harm, but it is estimated to be around one in 10, and self-harm is more common in females than males.
Why do people self-harm?
The underlying causes of self-harm are complicated and often unclear. Self-harm may occur in response to a person attempting to communicate feelings of sadness, and/or to express a need for support. Self-harm may also provide the person with a sense of control and temporary relief. Teenagers suffering from depression, low self-esteem and self-hatred are most at risk for self-harm. Self-harming behaviours may be triggered in response to stressful life events (the breakdown of a relationship, bullying, family breakup or experiencing any form of abuse).
What students can do about self-harm
Given the serious nature of self-harm, professional help is always recommended. GPs are a great place to access referrals to other psychological support services, such as counsellors, psychologists or psychiatrists if needed.
Although self-harm may not be directly related to suicidal thoughts, it is important that the risk of serious harm and suicide be assessed. If self-harm functions as a coping strategy for a person, it can be helpful to focus on learning new distraction or coping strategies. If there are obvious triggers to self-harm that can be identified then coping strategies should be aimed at addressing these issues.
For example, if exam or test stress is an issue then learning to take time out from study may be important or providing additional support for the student on tips to avoid self-harm at school may be helpful. It's important to work with the student, develop a list of alternative behaviours that they can use to distract themselves from their self-harm urges so that they can build their confidence in coping without it.
ReachOut.com resources on self-harm
Recommended professional resources
What can I do now?
Encourage discussion of self-harm: try not to appear judgmental about the behaviour, or simply tell them to stop. This is important to ensure that the person continues to communicate about the issue
Check-in with the student about thoughts of suicide: although young people who self-harm are not generally intending suicide, it is very common for young people who self-harm to also have suicidal thoughts
Work out distraction plans for when the person feels at risk of self-harming
Encourage the person to seek assistance from a psychologist.