Health: Advice on ... Self-harm

Q: What is self-harm?

The term is used to describe a range of things that people do to themselves in a deliberate and usually hidden way. It can involve cutting, burning, scalding, banging or scratching, breaking bones, hair pulling and swallowing poisonous substances or objects.

There are a number of myths attached to self-harm. One is that self-harm is about "attention seeking". Most self-harm is actually done in secret, for a long time and it is often very hard for young people to find enough courage to ask for help. Self-harm is also sometimes thought of as a group activity, but this is rarely the case.

Q: Is self-harm common?

Research conducted by the Mental Health Foundation and the Camelot Foundation last year showed that one in 15 young people in the UK have harmed themselves. That equates to about two young people in every secondary school classroom.

Most young people who harm themselves are aged between 11 and 25. The average age at which they start is 12, but some children as young as seven have been known to do it. There is no such thing as a typical young person who self-harms. About four times as many girls as boys do it, but it is also a serious problem among young men.

Young people in residential settings are more likely to self-harm than their peers. This includes those in the armed forces, prison, sheltered housing or hostels and boarding schools. Lesbian, gay, bisexual and transgender young people, Asian young women and those with learning disabilities are also more likely to become self-harmers.

Q: What causes young people to hurt themselves?

Many find it almost impossible to understand why young people harm themselves, and how it could possibly help them to feel better. By deliberately hurting their bodies, young people often say they can change their state of mind so that they can cope better with any distress they are feeling. They may be using physical pain as a way of distracting themselves from emotional problems.

Triggers include being bullied, not getting on with parents, anxiety about academic performance, divorce and bereavement, unwanted pregnancy, abuse in earlier childhood and difficulties associated with sexuality. Problems to do with race, culture or religion are also recognised as reasons why some young people hurt themselves.

Q: What are the warning signs?

It is very difficult to tell whether someone is self-harming. One sign might be that they insist on covering up their bodies to hide their scars and bruises - even when it is warm.

They may avoid activities that involve showing themselves, such as swimming or games. Secretive behaviour and wanting to be alone a lot can be another indicator, as well as many of the usual signs of emotional distress - becoming withdrawn, quiet, appearing "washed out" and lacking energy could also suggest that there may be an underlying problem.

Q: What should I do if I suspect a young person is self-harming?

It is often best to discuss how the person is feeling and explain that you have noticed changes in their behaviour, rather than asking them straight out. Allow the young person to take the discussion at their own pace.

If a young person discloses they are self-harming, stay calm. What young people need is understanding, time and support. Offer to lend a hand in getting them professional help from a GP, counsellor, therapist or community psychiatric nurse. Organisations such as ChildLine, Samaritans and NSPCC can also help.

- Celia Richardson is director of communications at the Mental Health Foundation.

MORE INFO

- The Mental Health Foundation and the Camelot Foundation have produced two free publications about self-harm. The Truth About Self-Harm and Truth Hurts are available to download from www.mentalhealth.org.uk Call 020 7803 1101 for hard copies

- ChildLine 0800 1111

- Samaritans 08457 909 090

- NSPCC 0808 800 5000.