Self-harm is a behaviour that can cause a lot of stress and worry, both for the person exhibiting the self-harm, as well as the people who care about them. It can be confronting and upsetting for a parent to see cuts or scratches that their child has inflicted on themselves. Psychologists can often see individuals with self-harm behaviour. This may range from superficial scratches on an arm or leg, to more serious cutting, burning or self-poisoning.
What is Self-harm?
Self-harm is a phrase used by clinicians who work with adolescents and others. The phrase deliberate self-harm has been used to describe self-injury which may or may not include a suicidal intent. The Diagnostic and Statistical Manual of Mental Disorders (2013) defines self-harm as “nonsuicidal self-injury”. Although this definition is based on the idea of no suicidal intent, this does not exclude the fact that at times the individual can have suicidal thoughts, or even attempt suicide.
Anecdotal reports suggest that self-harm has increased significantly over the past few years, and the number of hospitalisations for self-harm has notably risen in Australia during the past decade. However, some self-harm behaviour does not require medical intervention, and not everyone who self-harms will go to hospital for treatment. One study found that only around 10% of self-harming adolescents they surveyed had attended hospital for treatment.
One Australian study found that nearly three times more females than males aged 15-24 years were hospitalised due to self-harm. Although rates of self-harm tend to be higher in adolescents in comparison to adults, both males and females, and people of all ages, can self-harm.
What does it look like?
The main form of self-harm appears to be cutting of the skin, with reports that 70% of individuals use this technique, with others citing self-poisoning (such as overdosing on medication). Self-harm can also be scratching the skin, hitting a part of the body on a hard surface or punching themselves. Females tend to use cutting and scratching as their main form of self-harm, with males more liable to hit or punch something.
Why do people self-harm?
Self-harm has been called “attention seeking” behaviour, however this is rarely the case. Individuals who self-harm cite various reasons as to why they do it, including escaping a negative mood, managing stress or self-punishment. For adolescents, it is thought that the main function of self-harm is to help them to manage their emotions. Unfortunately, some individuals choose to self-harm as a coping strategy, however any self-harm constitutes a safety risk to an adolescent’s physical and mental health and so needs to be taken seriously.
What can I do?
- Be patient and remain calm. Attend to any injury. The person may require first aid. If you are worried, take them to hospital.
- Take it seriously. Rarely is self-harm about getting attention.
- Be open about talking about it. This helps to build trust in your relationship. Acknowledge the small things as change may take some time.
- Validate and encourage – let the person know that you hear them, that this is painful and takes courage to talk about this.
- Take care of yourself. It can be tiring and difficult to provide support to someone who self-harms. You won’t be able to help them if you don’t take care of yourself first.
- Seek help from a professional, such as a psychologist. This allows the person to gain other, more helpful strategies to manage their emotions.
- Encourage the use of the Kids Helpline (1800 55 1800) and Lifeline (13 11 14) as a free 24 hours service on landlines to access support.
We are more than happy to be contacted for further information or to schedule appointments on 02 4929 2223.
Ms Kathryn Russell, MAPS
MClinPsych, BSocSc (Hon)