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Self-harm can be hard to understand. A lack of knowledge about self-harm can make it harder to provide support and signposting.

We spoke to Dr Ritu Mitra, Consultant Child and Adolescent Psychiatrist, to find out the truth behind the myths and how you can support a young person who has self-harmed.

A woman with brown skin and long, brown hair is smiling – she’s wearing a blue lanyard. She’s listening to a person wearing red-framed glasses with short, black hair. They’re in a calm room with plants and a window, through which you can see the sun shining.

Myth one: all people who self-harm want to die

Dr Mitra says that ‘Sadly, some people who self-harm might also experience suicidal thoughts or feelings – but they don’t always come together.

‘Self-harm is usually a way for people to cope and manage when things are difficult – it doesn’t always mean someone wants to die, and someone’s self-harm isn’t necessarily an attempt to end their life’.

Myth two: people self-harm because they’re attention seeking

‘The truth is, a lot of people hide their self-harm,’ Dr Mitra says. ‘When people unhelpfully say self-harm is ‘attention seeking’, it can make it harder for people to ask for help and they can feel misunderstood and judged.

‘Different people self-harm for different reasons. It’s usually a way for people to cope with difficult thoughts or feelings. You might hear people talking about expressing something that’s hard to put into words, reducing overwhelming thoughts or feelings, punishing themselves, or getting rid of a numb feeling’.

For some people, self-harm is a way to show others that they need help. ‘If a young person self-harms as a way of bringing attention to themselves,’ says Dr Mitra, ‘they always need compassion and support and especially from the health professionals seeing them.

‘It’s OK for them to want other people to know how much they’re struggling. Over time, and with the right support, they can learn other ways to ask for the attention and help they need’.

Myth three: self-harm is a teenager thing – people will grow out of it

‘People of all ages self-harm,’ explains Dr Mitra. ‘It’s increasingly common among young people and this is concerning. Self-harm is a way of managing distress and it needs to be taken seriously. It’s an unhealthy way to cope, it carries risks, and it won’t address the root causes or the mental health problem of which it can often be a symptom’. 

Myth four: self-harm doesn’t hurt

Self-harm is different for everyone. ‘Some people might not be aware of the pain in the moment, for example, if they dissociate and disconnect from the world around them. But when this stops, they may suddenly feel the pain,’ explains Dr Mitra.

‘People have different pain tolerances. Some people may feel more or less pain than others, and for some people, feeling pain can be part of the reason they self-harm.

‘It’s important to remember that the clinical severity of injuries isn’t a representation of how distressed someone is. If adults comment on injuries (for example, calling them superficial), young people may feel like they need to cause more severe injuries to be taken seriously or helped’.

Myth five: self-harm is always obvious and easy to spot

Dr Mitra explains that there are risk factors that might make a young person more likely to self-harm. These include ‘finding it difficult to express their feelings, experiencing stressful events, or having a mental health condition, for example, depression’.

There might be clear indicators that a young person has self-harmed. ‘A young person might have unexplained marks on their body – or claim to have had a lot of accidents,’ says Dr Mitra.

‘They might have bloodstained clothes or bedding, or you might see bloody tissues in the bin. You might also notice that they’re covering their body more than they would usually – they might refuse to take jumpers or jewellery off, or they might not want to wear shorts or go swimming’.

However, there are also more subtle signs, such as ‘spending lots of time alone, seeming low or aggressive, or becoming more secretive. If you’re unsure, the best thing to do is have an open, non-judgemental conversation with them’.

Myth six: if I bring up self-harm, it might give a young person ideas 

Dr Mitra is keen to reassure people that asking a young person about self-harm doesn’t make them more likely to self-harm. ‘The research shows us that asking people about self-harm or suicidal thoughts doesn’t put the idea into people’s heads,’ she emphasises.

’If you notice something that makes you worry a young person might have hurt themselves on purpose, find a calm moment to talk about it with them. You can tell them what you’ve noticed, say that you know it can be a sign that someone has self-harmed, and ask them if they’ve hurt themselves on purpose’.