What is self-harm?
Self-harm has been described as ‘any act of self-poisoning or self-injury carried out by a person, irrespective of their motivation. This commonly involves self-poisoning with medication or self-injury by cutting’.
Self-harm can be expressed in children and young people of all ages; it is important to be aware that some children may be too young or lack cognitive understanding to be able communicate how they are feeling.
The aim of this toolkit is to provide practical tools and resources to aid practitioners to feel more confident in supporting all children and young people. We hope you find the resources valuable and please adapt them where necessary to meet the individual needs of the child.
‘Talk to me. Listen to me. Don’t just pass me on’ (young person in Hampshire).
Self-harm is primarily a way to cope with feelings that are so distressing that no alternatives are thought to be helpful.
The term ‘attention seeking’ is often used negatively in relation to self-harm. The implication is that the individual self-harms just to get attention, but it is important to understand that this is rarely the main motivation. Young people say that self-harm works for them in the following ways:
- Comfort: Self-harm may be experienced as soothing and comforting by some young people; this may come about from the release of tension, but also by providing an opportunity to seek care and nurture from others. This is particularly important for children/young people with poor self-regulation skills.
- Communication: Self-harm is primarily a means of regulating feelings rather gaining a response from others; however, self-injury may also be a means of communicating distress without using words.
- Control: Some children/young people explain that they feel the need for control in their lives (which are often characterised by a sense of lack of control). Self-harm can be seen in terms of gaining control – by controlling injuries to their own body. Determining the nature, site, timing and severity of harm to the body is a way of staking claim to one’s own body.
- Distraction: Self-harm can provide distraction from the internal emotional pain, which may feel unbearable.
- Feeling alive or real: Sometimes children/young people’s real life experiences leave them feeling numb or unreal. Hurting one’s body may be experienced as a way of breaking through these feelings, and experiencing something that makes them feel alive and real again.
- Relief of feelings: By hurting themselves, children/young people report they are able to release feelings that feel unbearable when held inside.
- Self-punishing: Some children/young people carry feelings of shame, low self-esteem, self-blame –when these feeling become hard to bear some young people harm themselves as a way of punishing themselves. This process may operate unconsciously.
‘Everyone has a way of coping. Some use self-harm, others use alcohol’ (young person in Hampshire).
‘Self-harm experience is unique to each individual. I did it to cope with anger, being out of control’ (young person in Hampshire).
Self-harm can be a risk factor for suicide. However, it is important to stress that most of those who engage in self-harm will not attempt suicide. Conversations which are supportive and empathetic are essential to help children and young people and their parents/carers understand the reasons for self-harm and ways it can be managed.
It is estimated that 8.4% of children/young people aged 5-16 years old in Hampshire will have a clinically diagnosed mental disorder.
Data published by Public Health England indicate hospital admission rates for self-harm in Hampshire for 10-14 year olds and 15-19 year olds are higher than England rates.
The Hampshire Health and Wellbeing Survey carried out between November 2021 and January 2022 found that:
- 78% of primary pupils, and 67% of secondary pupils said they are happy all or most of the time. Fewer secondary pupils said they were happy compared to 2019/20.
- 80% of primary and 61% of secondary pupils would tell an adult they trust if they were worried about a friend.
- 52% of secondary school pupils said they ‘worry a lot’ all or most of the time, and 55% said they ‘sleep well’ all or most of the time. Both outcomes are worse for secondary pupils compared to 2019/20.
- In primary, 32% of pupils said they ‘worry a lot’ all or most of the time, and 58% said they ‘sleep well’ all or most of the time. Levels of worry are slightly higher amongst primary pupils compared to 2019/20.