What is deliberate self-harm?

Self-harm is defined as:-

• The act of deliberately causing harm to oneself either by causing a physical injury, by putting oneself in dangerous situations and / or self-neglect.
• Intentional self-poisoning or injury, irrespective of the apparent purpose of the act (NICE, 2004).

Self-harm is NOT attention seeking behaviour; it is attention needing behaviour.  It is evidence that there is a problem that needs to be addressed.  It is an expression of personal distress, usually made in private, by an individual who hurts home or herself.  The nature and meaning of self-harm, however, varies greatly from person to person.  In additional, the reason a person harms him or herself may be different on each occasion and should not be presumed to be the same.

Self-harm can take a number of forms including cutting, overdose of tablets or medicine, punching oneself, pulling out hair or eyelashes, burning, scratching, picking or tearing of one's skin, inhaling or sniffing harmful substances, head banging, self-neglect, including failing to eat or purging after having eaten - any behaviour that could cause harm to oneself.

Why do people self-harm?

Self-harm is a way of coping and obtaining relief from a difficult and otherwise overwhelming situation or emotional state.  Someone who self-harms is usually in a state of high emotion, distress and inner-turmoil.  Research has shown that many people who harm themselves are struggling with intolerable distress or unbearable situations and this can provide a distraction from emotional pain.  A person will often struggle with difficulties for some time before they self-harm.

Situations that can trigger self-harm:

• Relationship problems with partners, friends or family
• Pressures e.g. school work and exams, sporting performance, family issues
• Bullying
• Trying to fit in (some social groups are more accepting of self-harming behaviours)
• Feeling bad about oneself (guilt, shame, worthlessness)
• Physical, emotional or sexual abuse
• Feeling depressed

Young people are more likely to self-harm if they feel:

• That people don't listen to them
• Hopeless or worthless
• Isolated, alone
• Out of control
• Powerless - it feels as though there is nothing they can do to change anything
• Unable to experience emotional pain even for a short period of time.

Self-harm and Suicide:

Whilst self-injury and suicide are separate, those who self-injure are in emotional distress and those who end their lives are also in emotional distress.  In addition, there is always the danger that self-harm could go wrong and cause death, although this may not have been the intention.  It is vital that all emotional distress is taken seriously to minimise the chances of self-injury, and suicide.  Any warning sign or talk of suicide must be taken seriously.

What to do if a young person discloses that they are self-harming:

• Listen to the young person in emotional distress calmly and explain that you are not judging their behaviour
• Do not make promises which cannot be kept (e.g. assuring confidentiality).  Reassure the young person that in order to seek health and happiness people need to know about their problems so that they can help
• Try to remain calm (even if you do not feel it).  Strive to be accepting and open-minded.  Young people who self-harm can find it very hard to talk about what has happened and are often afraid of how people will react.  The reaction a young person receives when they disclose their self-harm can have a critical influence on whether they go on to access supportive services.  Any indication of a negative emotion or being judgemental is likely to aggravate the situation
• If the wounds are fresh, seek first aid treatment and assessment
• Members of staff should report incidents of self-harm in the same way as other safeguarding issues
• Where parents or carers are aware of such instances, we would strongly recommend that the Academy is informed.

What not to do:

• Do not ask why the young person has self-harmed
• Do not try to be their therapist - therapy is complicated and best left to the professionals
• Do not react strongly - this is likely to make the young person feel worse
• Do not try to make the young person promise not to do it again