But with the NSPCC reporting that an increasing number of children and young people are being admitted to hospital for self inflicted injuries - 18,778 in the last year, that’s an increase of 14% over the last three years - it is only becoming more important to open this channel of conversation.
“A frightening number of children and young people are being driven to self-harm as a way of dealing with unresolved feelings, tensions and distress in their lives,” an NSPCC spokesperson said on Self-Injury Awareness Day Wednesday 1 March.
“It is therefore vital we confront the fact that many of our younger generation are struggling to deal with the pressures and demands of modern-day life and make sure they have somewhere to go for help, be it from a parent, a trusted adult or Childline.”
Many children’s charities and psychiatrists agree - talking is an essential component in helping a young person develop alternative coping strategies.
The survey of nearly 1,000 parents and 3,800 young people up to the age of 24 who self-harm commissioned by ChildLine, The Mix, SelfharmUK and YoungMinds, found that 39% of parents believe one of the main reasons young people self-harm is “to seek attention”.
However, 80% of the young people questioned answered the open question “Is there anything else you would want people to know about self harm?” by saying they wished people didn’t think self-harm was attention-seeking.
They said the main reasons for the behaviour were low self-esteem, bullying and depression.
John Cameron, head of helplines for ChildLine, said: “Many parents really want to offer support for self-harm, but don’t know how to broach the subject with their children; meanwhile the stigma and misconceptions around it, including the fact that many people see it as just attention-seeking behaviour, can make it more difficult for young people to be open with their parents.”
So, how can you tell if your child is self-harming?
Self-harm can take many forms, from self-injury to eating disorders, risk taking behaviour, drug or alcohol abuse, so there won’t always be physically visible signs, but there are changes parents can watch out for if they are concerned about their child.
“Your child may seem very down and talk about being a failure or feeling unhappy,” explained Jeremy Todd, chief executive of the charity Family Lives.
“They may take to wearing many layers of clothes, or trying to hide or downplay injuries.”
Dr Alys Cole-King, consultant psychiatrist and Royal College of Psychiatrists spokesperson on self-harm added: “Things to look out for include changes in behaviour, especially isolation from family and friends.
“During adolescence self-harm may also be associated with symptoms of depression and anxiety.”
“Self-harm is a sign of emotional distress; an indication that something else is wrong rather than a disorder itself,” explained Cole-King.
“It is a way of coping with difficult or intolerable emotions and situations. For each person, the underlying reasons are different.
“The good news is that for most young people who self harm they develop better ways of coping and it resolves when they are able to develop less harmful coping strategies.
“‘Talking not Harming’ is an important transition in the road to recovery.”
Todd adds: “Self-harm is a way of channeling frustration and other strong emotions. In the vast majority of cases, it is not a suicide attempt, but rather a way to let off steam.
“Self-harm is not a form of attention-seeking. People who self-harm tend to do so in private and try their utmost to conceal their injuries.”
What can parents do if their child is self-harming?
“The hardest thing for parents or guardians to accept is that they cannot physically stop their child from self-injuring,” explains Wedge, the founder of self-injury guidance support network LifeSIGNS.
LifeSIGNS marks Self-Injury Awareness Day on 1 March every year, as they feel it is important to distinguish self-injury from other forms of self-harm, such as risk taking behaviour or eating disorders.
“It’s definitely a breakthrough if the parent and child can talk about self-injury and the emotional distress behind it,” continues Wedge. “But parents shouldn’t expect the self-injury to go away anytime soon.
“Emotional recovery takes time, and people (of all ages) that rely on self-injury as a coping mechanism need support to learn new ways of coping.
“Self-injury is a reaction to intolerable stress and distress, and so the situations behind the self-injury also need addressing. A parent should be just as worried about the situation as they might be about the self-injury.
“Being listened to by your parents is incredibly validating and very helpful, so parents should learn the skill of listening without judging and without attempting to fix everything every time. Children of all ages want to be heard.”
LifeSIGNs advises that issuing a demand or ultimatum for someone to stop hurting themselves “can only serve to drive your loved one further away from you, as you demonstrate that you don’t understand and that you’re not listening.
“A person who self injures may well feel isolated and alone; ultimatums only increase the feelings of isolation.
“As self injury is a coping mechanism it is not reasonable to take it away before providing a suitable replacement mechanism, or strategy for coping.”
Dr Cole-King added: “It is never too late to take action to help a situation that seems hopeless.
“Every contact with individuals who self-harm is a chance to address the unbearable emotional distress that they are feeling.”
The YouGov poll also found that 67% of parents believe young people who self-harm should ask their parents for help. But only 16% of young people who self-harm would consider that an option.
“Shame and fear of discovery mean that young people often keep self-harm a secret,” said Dr Cole-King.
“It is therefore vitally important that concerned adults should respond in a caring and non-judgemental way. This will create a good foundation for your discussions.
“Thousands of young people every day experience overwhelming thoughts of self-harm, but they do find ways to get through these intense feelings - like them, your child or the young person you care about can get through it.
“Secrecy is the big enemy here. Simply talking about it is the most important thing. Simply asking a young person if everything is OK.”
Young Minds has collated the following five tips for parents, from a young person who self-harms:
* Try not to judge: “My parents didn’t like it but they didn’t think it made me a bad person.”
* Be honest: “My parents told me they didn’t get it - nor did I. Their honesty and questions helped me to open up about it.”
* Accept recovery is a process: “I can’t stop. Not right now. If you ask me to, I’ll feel like I’m letting you down. It’s going to take time.”
* Listen: “My dad said very little. He just listened. It was exactly what I needed.”
* Talk about other things too: “I’m more than my self-harm. It doesn’t have to be the focus of every conversation.”
How can parents remain calm when the idea of their child being injured is naturally distressing?
YoungMinds advise: “Many parents find themselves paralysed with fear of saying the wrong thing to their child and so they say nothing at all.
“One time you should say nothing is if your emotions are running high – then it’s best to give yourself space and time to calm. The rest of the time, even if you don’t get it quite right, each conversation is a show of support for your child.
“Acknowledge your feelings, perhaps by talking to a partner, friend or counsellor. Try not to focus on the past, instead think about how you can help make things change. Many parents grow closer to their children as they support their recovery.”
How else can you help someone who is self-harming?
“If your child comes to you with an injury stay calm and don’t over-react,” advised Todd. “With the right help and support you can help your child to come through this, and your relationship with them may even improve as a result.
“Jane, a parent who has cared for a child who self-harmed, said: ‘Your child isn’t trying to kill themselves, but they’re scared so don’t add to it. Sit them down and treat the wound, or seek medical attention, if necessary. You don’t even have to comment on the fact that it’s happened. Don’t try to extract information or put pressure on them to talk to you. When they are ready they will come to you and talk’.”
It is important to acknowledge the feelings that are leading your child to self-harm. Nia Charpentier from charity Rethink Mental Illness explains:
“Feeling in control is often identified as a major factor in why a person may self-harm or injure themselves and so understanding the stresses and pressures a person is facing, and thinking of ways to reduce these, can be very important in helping someone who is, or feels that they want, to injure themselves.
“Accepting and understanding that someone is in pain doesn’t make the pain go away. But it can make it more bearable for them to know that someone understands. Be hopeful about the possibilities of finding other ways of coping rather than self-harm.
“If they are reluctant to engage in conversation, writing a letter or drawing a picture may also be a good avenue to enable them to express their feelings. If possible make sure they have a safe place and be as available as you can be.
“Using punishments or trying to make them feel guilty is not helpful and is likely to make things worse. Hiding pills or sharp objects may be necessary in a crisis, but they may just find alternative ways to self-harm and will not address the underlying issue.”
You don’t have to go it alone.
“Your first port of call may be your GP, unless it’s an emergency, who can refer you to the relevant CAMHS (Child and Adolescent Mental Health Service), who will be able to provide the appropriate support – from counselling, therapy or medication,” says Charpentier.
Wedge adds: “Parents should respect their child’s privacy when visiting a doctor or counsellor.”
LifeSIGNS is a support network managed and led by people with personal experience of self-injury.
Staying Safe is an interactive online resource for anyone struggling to offer hope, compassion and practical ideas and suggestions on how to find a way forward.
Childline: Free national helpline for young people, confidential advice on all sorts of problems: 0800 1111.
The Mix: Offers help by telephone and email for people under 25 who self-harm: 0808 808 4994.
Selfharm.co.uk: a project dedicated to supporting young people who are affected by self-harm.
Royal College of Psychiatrists leaflet on self-harm.
The Rethink Mental Illness advice service can be reached on 0300 5000 927 (lines open Monday to Friday 10am-2pm and calls charged at local rate). For information and advice if you are worried about someone who is self-harming, download their factsheet.
YoungMinds Parents Helpline: 0808 802 5544 is available Monday to Friday 9.30am to 4pm.