Self-harm in young people - advice for parents and carers from Karen Price, our Social Prescribing Link Worker for Children and Young People in the North Cotswolds

Karen Price, our Social Prescribing Link Worker for Children and Young People in the North Cotswolds, recently attended some very valuable training about self-harming behaviour in children and young people.

Karen Price, our Social Prescribing Link Worker for children and young people in the North Cotswolds.

Karen Price, our Social Prescribing Link Worker for children and young people in the North Cotswolds.


"I'm keen to share some of the key ideas from the training which challenged us to really think about the subject of self-harm," said Karen.  "The essential message was that we should treat individuals who are possibly self-harming with Care, Compassion, Dignity and Respect in every encounter we have, and not be afraid to have conversations that could be life-changing for them".  

According to the Nice guidelines, "Self-harm refers to an intentional act of self-poisoning or self-injury… an expression of emotional distress."   Self-harm behaviours might include ligatures, inserting or ingesting objects, overdosing, hair pulling, head banging, burning, cutting, pinching, scratching or self-hitting, but eating disorders, substance abuse, and alcohol misuse are not generally classified as self-harm because there are separate services that deal with these issues, explained Karen.

Reasons for self-harm are varied, but could be anything that causes an individual distress.  "An event may seem small and insignificant to you, but to the person self-harming, it could be huge," said Karen.  "For example, getting a B in an exam, instead of an A, could lead to a feeling of failure. It is important that if someone discloses self-harm to you, you do not dismiss or judge."

How can you recognise the signs of self-harm in young people? 

"Ideally, we want to get to our young people before they are self-harming," said Karen.  "If we have any concerns, we should always be looking for signs of distress. Look for changes in a young person’s behaviour that could be an indicator of distress. This could be isolating themselves, changes in routine, engaging in risky behaviour, or changes in behaviour in school or college.   Not all methods of self-harm have external signs, so it's important to focus on the bigger picture.  However, some visible signs may include wearing baggy clothing, blood-stained bedding, finding small blades from sharpeners or razors lying around,  or finding empty medication packets."

How can you start a conversation about self-harm with a young person?

Parents and carers might worry about starting conversations about possible self-harm with their young people.  "It's best to check in with them regularly, and this may enable you to notice if there are any signs of distress," advised Karen.   "Choose the time for starting conversations very carefully. Make sure everyone is calm, and leave plenty of time.  Don’t go into conversations cold, or focus conversations on suspected injuries – this could make a young person feel victimised.  It may even be appropriate to address concerns at the end of a conversation and not at the beginning."

"Always show care and compassion," said Karen, and you might like to try using phrases such as these:

  • ‘Is everything ok with you at the moment?’
  • ‘I noticed a mark on your arm.’  (Don’t assume it is self-harm, it could be a number of things.)
  • ‘That looks sore, did you want me to have a look?’
  • ‘Thank you for telling me, that must have been difficult.’ (Be sure to acknowledge any disclosure.)
  • ‘If you want to talk about it at any point, I will be here.’
  • ‘Can I find you some support?’

Although, self-harm does not usually directly lead to suicide, said Karen, talking about suicide and suicidal thoughts is important.  "We all need to have open conversations with our young people about suicide. Let’s reduce the stigma!"

Are there any phrases or language to avoid?

"It's best not to say things like 'You're so lucky to be you'," said Karen.  "Just because you perceive them to have a happy life, they may be deeply distressed. To dismiss is to undermine, and they may not trust anyone to disclose in the future." 

Useful resources about self-harm 

Karen recommends the following resources if you need to find information and advice about dealing with self-harm:

The training course that Karen attended was delivered by