App reduces young people's urge to self-harm

Calm Harm app helps children and young people manage the urge to self-harm.


Calm Harm


Charity Stem4 fundraised £45,000 to develop the app prototype and further development was funded by NHS England


In the course of its work delivering mental health education in schools, Stem4 became aware of a lack of support for young people who might not meet the threshold for mental health services but wanted help from a valid and trusted source on dealing with self-harm. "I could see it was hard for young people to access NHS specialist intervention," says Stem4 founder and, consultant clinical psychologist Dr Nihara Krause. Dr Krause felt a smartphone app could offer accessible support.


Launched in 2015, the Calm Harm app was redesigned in 2017 with input from young people with experience of self-harm. In June 2017, it received NHS approval, and has been included in the NHS App Library.

Calm Harm aims to help young people to resist or manage the urge to self-harm and is informed by Dialectic Behaviour Therapy. This is a type of talking therapy based on cognitive behavioural therapy, which has been adapted to help people who experience emotions very intensely.

The password-protected app teaches children and young people impulse control and emotional regulation through a selection of activities. "Distract" tasks help young people to combat the urge to self-harm by improving their self-control such as by thinking of a country for every letter of the alphabet. "Comfort" activities help them care for rather than harm themselves while "release" tasks promote safe alternatives to self-injury. Meanwhile, "express yourself" activities help young people get their feelings out in a different way. For example, this could include writing down what is upsetting them and then tearing up the paper. Users can also add their own tasks and monitor the triggers to self-harm.

Stem4 is currently exploring partnerships with Public Health England and the NHS using a licensing model, and is also looking into translating the app into different languages.


Calm Harm recorded 307,845 user sessions from 123,138 individuals in the UK between April 2017 and November 2018. More than a quarter - 26 per cent - were aged between 19 and 22, while 34 per cent were aged between 10 and 16, and 20 per cent were aged 17 or 18. After using the app, 94 per cent of users reported that the urge to self-harm had reduced.

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