Understanding self-harm in children and young people

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Self-harm is when a child or young person hurts themselves or puts themselves in danger. They can do this in different ways, such as:

• Cutting, scratching, stabbing, burning, hitting or biting themselves.  
• Pulling their hair.
• Picking at their skin.
• Tying things very tightly around the neck, fingers, wrists, etc.  
• Punching things, e.g. walls, doors.  
• Banging their head.
• Throwing themselves onto hard surfaces.
• Holding their breath.
• Choking themselves.
• Starting fights.

Older children and teenagers might also show the following self-harm behaviours:

• Overdosing on medication.
• Using drugs or alcohol, especially in high quantities.
• Taking extreme risks, e.g. doing dangerous activities, meeting strangers, having unsafe sex.
• Disordered eating.

Note that these behaviours are not exclusive to older children and teenagers, but they tend to be more common in these age groups than in younger children.

What are the signs of self-harm in children and young people?

The following signs might suggest that a child or young person is self-harming.

• Unexplained or frequent injuries, e.g. cuts, bruises, burns.
• Bald patches of hair.
• Sores, scratches or scabs on their skin.
• Acting defensive or secretive when asked about injuries.
• Wearing clothes that cover their arms and legs, even in warm weather.
• Refusing to get changed in front of other people, e.g. for PE or swimming.
• Complaining of physical illness, potentially to get access to medication.
• Viewing self-harm-related content online.
• Talking about hurting themselves or not wanting to live.
• Experimenting with drugs, alcohol or other risky behaviours.
• Undereating or overeating.
• Exercising excessively.

The following signs also suggest that a child or young person is struggling with their emotional or mental health, whether or not they’re self-harming:

• Difficulty concentrating or paying attention.
• Withdrawing, isolating themselves, or wanting to be alone.
• Seeming tired or falling asleep throughout the day.
• Seeming unmotivated or uninterested in their usual daily activities or interests.
• Seeming anxious, restless, agitated or irritable.
• Becoming easily upset or tearful.
• Having intense emotional outbursts.
• Finding it difficult to calm down or regulate their emotions.
• Being aggressive towards others.
• Being unusually clingy towards caregivers or other adults.
• Spending excessive time online or on social media.
• Being secretive or defensive about their online or social media use.

Next: Why do some children and young people self-harm?

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