Advice for professionals: what to do if a child is self-harming
Finding out a child in your setting is self-harming is very worrying and it can be tricky to decide what practical steps you need to take in order to help them. Here, YoungMinds, The Charlie Waller Memorial Trust, and The Royal College of Psychiatrists give their advice on how to cope if you discover that a child you know is self-harming, based on conversations with young people and professionals who have had experience of it. These resources form part of the #NoHarmDone campaign - you can tweet to spread the word, or go here to find more information on how you can help.
Self-harm describes any way in which a young person might harm themselves or put themselves at risk in order to cope with difficult thoughts, feelings or experiences. It affects up to 1 in 5 young people and spans the divides of gender, class, age and ethnicity. As such, many people find themselves in the position of wanting to support a young person who is self-harming. It can be daunting, but your support is vital and can be life-changing for the young person who is hurting themselves.
There are many signs you can look out for which indicate a young person is in distress and may be harming themselves, or at risk of self-harm, the most obvious being physical injuries which:
- you observe on more than one occasion.
- appear too neat or ordered to be accidental.
- do not appear consistent with how the young person says they were sustained.
Other warning signs include:
- secrecy or disappearing at times of high emotion.
- long or baggy clothing covering arms or legs even in warm weather.
- increasing isolation or unwillingness to engage.
- avoiding changing in front of others (may avoid PE, shopping, sleepovers).
- absence or lateness.
- general low mood or irritability.
- negative self-talk – feeling worthless, hopeless or aimless.
The first conversation
“It was the hardest conversation of my life, but every word I spoke made the load feel a little lighter and for the first time in a long time, I felt hope.”
The sooner we encourage a young person to disclose their self-harm, the sooner we are able to provide or seek appropriate support to help them break the cycle. We can do so by passing our concerns on to a safeguarding officer or by providing a safe space for the young person to talk to us. Make sure that during this first conversation with the young person, they are the sole focus of your attention and that most of your time is spent listening to them in a calm and non-judgemental way. Also, make sure that you are realistic with them about confidentiality and that you recognise that this is the first step of a difficult journey. Afterwards, it's important to identify next steps and to follow them up promptly.
When a young person isn't ready to talk
When a young person is more reluctant to disclose or discuss their self-harm, three important questions to consider are:
- Who is the best person to have this conversation? You can use your knowledge of the young person, or ask them who they feel comfortable talking to.
- How can you help the conversation flow? An informal environment or talking while carrying out another activity such as walking or drawing can really help.
- Would another medium work better? Some young people feel happier talking via instant messenger, text or email – be creative and use your knowledge of the child.
“I tried several times to talk to him to no avail; it was only when I texted him that the conversation finally started.”
If a young person still isn’t ready to open up, provide them with details of anonymous sources of support and regularly revisit the situation.
If you are concerned about their safety
If you're worried about a young person's immediate safety, this is an absolute priority and should be treated as an urgent safeguarding issue in line with your policies. If you think a young person is at risk, they should not be left alone. All discussions should be recorded and shared with your safeguarding officer who will keep these details on file and can provide support and direction on appropriate next steps.
These might include:
- Informing adults who need to know in order to keep the young person safe. This will usually include parents or carers.
- Visiting the GP to seek further support and guidance.
- Providing access to a school counsellor.
- Setting up regular meetings with a trusted adult such as a form tutor who can provide practical support and guidance.
It is important that all wounds are appropriately dressed and cared for as infection is common. Provide the young person with information about wound care or access to a trained first aider or medical professional who can assess and dress any wounds.
Providing practical support
If you find yourself in the position of providing regular support to a young person, here are some helpful things you can do:
Listen – provide a safe space for non-judgmental, supportive listening. Even a few minutes of high quality listening can make a huge difference to how supported a young person feels.
Address stressors – work with the young person to understand their triggers and stressors. Working through a typical day and highlighting the tough bits can be a great way to start and then think creatively of ways you might address these.
Make a self-soothe box – work with the young person to collect a range of different things they can use to distract or soothe themselves when they feel the urge to self-harm. This might include music, colouring, books, bubbles, photographs or inspirational quotes.
Provide safe sources of further information – highlight sources of further information such as those in the young people's digital pack for ‘No Harm Done’.
Safeguarding you own wellbeing - It can be emotionally challenging to support a young person who is self-harming so it’s important that you too receive regular support and confidential listening. Keep in regular contact with your safeguarding officer and if, for any reason, you feel you are unable to continue to support the young person, discuss this at the earliest opportunity.
“Things changed for me at home and I felt unable to provide the level of support she deserved. I was honest with her and we identified a different adult she could regularly speak to.”
- YoungMinds www.youngminds.org.uk Parents Helpline 0808 802 5544 (Monday to Friday 9.30am – 4pm)
- Factsheet from The Royal College of Psychiatrists
- A Short Introduction to Understanding and Supporting Children and Young People Who Self-Harm by Professor Carol Fitzpatrick. Available as a paperback or Kindle.
- Self-Harm Alternatives: over 130 ideas for use in recovery suggested by young people, collated by Dr Pooky Knightsmith