What is Self-Harm?

This article discusses self-harm and depression. If you or someone you know needs immediate support please contact a mental health professional or crisis service.

Self-harm is when a person deliberately hurts their own body as a way of coping with overwhelming emotional distress. It is important to understand that self-harm is not usually an attempt to end one's life. It is most often an attempt to manage unbearable feelings when no other coping mechanism feels available.

Young people who self-harm are not seeking attention in the dismissive sense that phrase is sometimes used. They are communicating distress in the only language available to them at that moment.

According to the World Health Organisation self-harm is most common among young people aged 15 to 24 and is significantly more prevalent among girls than boys although it affects young people of all genders, backgrounds and cultures.

Warning signs to look for

Parents and educators should be aware of the following signs which may indicate a young person is struggling:

Unexplained cuts, bruises or burns, particularly on arms, legs or stomach. Wearing long sleeves or long trousers in warm weather. Withdrawal from friends, family and activities they previously enjoyed. Significant changes in mood, eating or sleeping patterns. Expressions of hopelessness, worthlessness or feeling like a burden. Giving away possessions or saying goodbye in ways that feel final.

It is important to note that the presence of one or more of these signs does not confirm that a young person is self-harming, but it is always worth paying attention and creating space for a conversation.

How to respond

If you suspect a young person is self-harming the most important thing you can do is respond with calm, compassion and without judgement. A response of shock, anger or disgust, however understandable, is likely to cause the young person to shut down and hide the behaviour more carefully.

Try to find a quiet, private moment to say simply: I have noticed that you seem to be going through something difficult. I am not here to judge you. I just want you to know that I am here and I care about you.

Then listen. Resist the urge to fix, advise or minimise. Just listen.

Professional support is essential and should be sought as soon as possible through a doctor, school counsellor or mental health professional.

How bibliotherapy can help

Books cannot treat self-harm. That must be said clearly. Professional support is always the priority.

But books can do something that professional appointments and wellbeing programmes sometimes cannot. They can reach a young person in their private space, in their own time, without the vulnerability of face to face disclosure.

Reading about a character who has navigated similar darkness and found their way toward healing can reduce the sense of shame and isolation that often keeps young people locked in cycles of self-harm. It can open conversations that direct approaches cannot.

At The Harbour Library our Safe Harbour and Steady Waters collections contain titles that speak to young people navigating extreme emotional distress with honesty and compassion. We recommend these always as a complement to professional support rather than a replacement for it.

If you or someone you know needs help now

Please reach out to a mental health professional, doctor or school counsellor immediately. In a crisis contact your local emergency services or a crisis helpline in your country. The International Association for Suicide Prevention maintains a directory of crisis centres worldwide at https://www.iasp.info/resources/Crisis_Centres/

You are not alone. Help is available. And healing is possible.

Find supportive reading at www.theharbourlibrary.com

References

- Hawton, K., Saunders, K.E., & O'Connor, R.C. (2012). Self-harm and suicide in adolescents. The Lancet, 379(9834), 2373-2382.

- International Association for Suicide Prevention. (2023). Crisis centres directory. IASP.

- National Institute for Health and Care Excellence. (2022). Self-harm: Assessment, management and preventing recurrence. NICE Guidelines.

- Nock, M.K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339-363.

- World Health Organisation. (2021). Suicide worldwide in 2019: Global health estimates. WHO.