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Supporting Children with Medical
and Mental Health Needs at School


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Self-harm is when someone injures or harms themselves on purpose as a way of coping with difficult feelings that build up inside.

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  • People self-harm because they are in pain and trying to cope.
  • They could also be trying to show that something is wrong. They need to be taken seriously.
  • Self-harm is always a sign of something being seriously wrong.
  • Young people often self-harm if there is a crisis in a close relationship
  • Common examples include `overdosing' (self-poisoning), hitting, cutting or burning oneself, pulling hair or picking skin, or self-strangulation. 
  • It can also include taking illegal drugs and excessive amounts of alcohol. 

People say different things about why they self-harm

  • Some say that they have been feeling desperate about a problem and don't know where to turn for help.
  • They feel trapped and helpless. Self-injury helps them to feel more in control.
  • Some people talk of feelings of anger or tension that get bottled up inside, until they feel like exploding.
  • Self-injury helps to relieve the tension that they feel.
  • Feelings of guilt or shame may also become unbearable.
  • Self-harm is a way of punishing oneself.
  • Some people try to cope with very upsetting experiences, such as trauma or abuse, by convincing themselves that the upsetting event(s) never happened.
  • These people sometimes suffer from feelings of 'numbness' or 'deadness'.
  • They say that they feel detached from the world and their bodies, and that self-injury is a way of feeling more connected and alive.
  • A proportion of young people who self-harm do so because they feel so upset and overwhelmed by difficulties that they wish to end their lives by committing suicide.
  • Often, the decision to attempt suicide is made quickly without thinking.

Symptoms of self-harm

  • Changes in behaviour that present as the young person being upset, withdrawn or irritable. 
  • Self-injury is often kept secret but there may be clues, such as refusing to wear short sleeves or change for PE/swimming 

Help for self-harm

  • Talking to someone they trust
  • Self-help group (group formed of young people that all self-harm) 
  • CBT 
  • Psychotherapy 
  • Group therapy (lead by a professional) 

Supporting students who self-harm

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Understanding self-harm

  • Young people self-harm as a way of dealing with very difficult emotions. Try to understand their feelings of distress. 
  • Listen carefully to what a young person says do not assume you know how they feel. 
  • Try to be non-judgemental when dealing with incidents of self-harm. 
  • Help young people to think about their self-harm not as a shameful secret, but as a problem to be sorted out.

Dealing with self-harming behaviour

  • Don’t struggle with someone when they are about to self-harm – it's better to walk away and to suggest they come and talk about it rather than do it.
  • If they do decide to self-harm talk calmly and request that they take care of their immediate physical needs, e.g. clean and dress wounds. 
  • Try to understand the triggers that lead individual young people to self-harm.
  • Help them to find out about self-harm and available help by providing information by organisations such as Young Minds. 

School policy and protocols

  • Ensure all staff are informed of the school’s self-harm protocols and safeguarding policy.

Young People who self-harm - New Resource for School Staff

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HOPE (Hospital Organisation of Pedagogues in Europe)