Safeguarding: self-harm - In the latest in our series of articles about specific safeguarding concerns, we look at the issue of self-harm, a safeguarding issue for many teenagers and young people, and something that is often misunderstood by parents and carers. Whilst most young children do not self-harm, it can happen, and you should be particularly aware of your young staff in the most vulnerable age ranges of 16-25.
According to the charity, Young Minds, one in six children aged 5 to 16 were identified as having a probable mental health problem in July 2021, a huge increase from the one in nine children identified in 2017. Many other statistics reveal a similar upward trend, such as the increase in young people aged 18 or under attending A&E with a recorded diagnosis of a psychiatric condition, or the fact that over 80% of young people with a mental health condition reported that the coronavirus pandemic had made their condition worse. Mental health is a very real problem for many of today’s young people.
Self-harm incidence is also increasing, and the statistics are worrying. In 2018-19:
- 24% of 17-year-olds reported having self-harmed in the previous year
- 7% reported having self-harmed with suicidal intent at some point in their lives, and
- Nearly half of 17-19-year-olds with a diagnosable mental health disorder reported having self-harmed or attempted suicide at some point, rising to 52.7% for young women
Our young people are a real risk here and we need to do everything we can to protect them.
What is self-harm?
Self-harm (self-abuse, self-injury, or self-mutilation) is when people deliberately hurt themselves without intending to kill themselves. It is often referred to as “non-suicidal self-injury” or NSSI. There are several ways that people self-harm including:
- Cutting: using a sharp object to cut and make incisions on their arms, hands, legs, or other body areas. Cutting can leave scars and many young people who cut themselves often try to cover up the scars by wearing long sleeves even in hot weather
- Excessive scratching: this can often occur in one spot and be so intense as to draw blood
- Punching things: some sufferers punch walls and trees repeatedly until they either bruise their knuckles or hands
- Ingestion of dangerous substances: these can include bleach and detergents
- Head-banging: some people will repeatedly hit their head on a table, wall or desk
- Excessive drinking or substance misuse: this is also a form of self-harm
Myths to dispel about self-harm
As previously mentioned, self-harm is often misunderstood by parents/carers and family and friends and there are some myths about self-harm which need to be addressed and dispelled.
- Firstly, self-harm is not an attention-seeking or ‘dramatic’ behaviour. Most people who self-harm do so to exert some control over their lives when they feel totally out of control. They often also try to hide it rather than advertise the fact that they have done it to gain attention
- Self-harming does not automatically mean that people want to commit suicide, although when self-harm continues for long periods, research shows that these children are at higher risk of suicide attempts
- There is a perception that self-harm is a teenage girl problem, but boys can self-harm too and being gay or transgender can increase the risk
- Although many teenagers do stop self-harming as they grow older, this is not guaranteed, and treatment is always needed
- Talking about self-harm will lead children to do it. There is no firm evidence for this, although some pressures and influences from social media can negatively influence some people
Why do people self-harm?
There is not one identifiable reason why people self-harm. However, there is usually a feeling of overwhelming emotional distress in people who do. Victims often report feeling empty or worthless inside, feeling disconnected or lonely and at that point, they want to do something to make themselves feel better. Self-harm is not about seeking attention from others, but more about people trying to control something in their lives when they feel lost or unable to control other things. For some sufferers, it is a way that get to “feel something”, even a negative something like pain, when they feel shut off from their emotions.
Other reasons include:
- Expressing or coping with emotional distress
- Trying to feel in control
- A way of punishing themselves
- Relieving unbearable emotional distress
- A cry for help
- A response to intrusive thoughts
Understanding self-harm is often difficult for others, but on a scientific level, when people injure themselves, there are chemical reactions that happen and the body releases various endorphins to help us cope with the pain. These endorphins may give the self-harmer a short burst of something to relieve the emotional pain they feel.
As with many safeguarding scenarios, a person’s behaviour may be a way of trying to communicate that there may be other issues involved such as trauma, abuse, bullying, bereavement, low self-esteem, and depression to name but a few.
How to react/help a person who self-harms
Safeguarding - The NHS website has a list of ‘Dos and Don’ts to inform people of the best way to help people who self-harm. These include:
Things to do
- Listen and be compassionate, never judgemental
- Treat any self-harm with medical first-aid
- Encourage them to speak to a GP or a charity specialising in mental health/self-harm such as the Young Minds, Mind or The Samaritans
- Ask how they would like to be supported
- Let them know you're there for them, now and in the longer term
- Remind them about their positive qualities
- Try to understand their emotions and experiences, without judging them, rather than focusing on their self-harm
- Understand that any amount of self-harm might be a sign that they're feeling extremely distressed
- Let them be in control of their decisions, but get them medical attention if needed
- Try to force them to change what they're doing
- Threaten to take away their control
- Insult them, for example by saying they're “attention-seeking”
If children have self-harmed, then you should always alert your DSL, which will normally alert other local partners to get the person some additional safeguarding support.