Children & parentsFor someone close50 min read

When your teenager self-harms: understanding it and helping

Marks on a forearm, long sleeves in the middle of summer, a stained tissue at the bottom of a bin: discovering that your child is hurting themselves turns everything upside down. This guide explains what the act does for them, what it says about suicide risk and why you must always ask the question. It then describes what to do: respond without punishing and without promising secrecy, recognise emergencies, make the home safe without turning it into a prison, and find the treatments that have proved themselves.

Reviewed on October 25, 2026
Dr Zayan Al-Falasi, psychiatrist

In short

This guide is for parents, and more broadly for adults raising a teenager, who have discovered or suspect that the young person is harming themselves. It draws on the leading British guideline on self-harm, published in 2022, and on the most solid research: how many young people are affected, what the act does for them, how it is linked to suicide, what helps and what makes things worse. It offers a course of action for the first few hours, a way of talking about suicide without beating about the bush, realistic safety measures and a plan for the first four weeks. It also covers school, social media, brothers and sisters, and what you yourself are going through.

Topic: Children & parents · Emotions · Depression & mood
Who it's for: For someone close
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The programme

This guide is psychoeducational content. It does not replace a consultation. Call the emergency services immediately if your teenager has swallowed more medication than the intended dose, or a dangerous product, even if they say they feel fine: some effects only appear after several hours. Call them too for a wound that is bleeding heavily despite firm pressure, a deep wound or an extensive burn, if they have just harmed themselves wanting to die, if they say they are going to try to end their life, if they have a specific plan or a means within reach, if they are confused or very drowsy, or if you cannot keep them safe: in that case, stay with them. If they say they are thinking about suicide but none of these situations applies, get advice the same day (section 9). If you are unsure, call the emergency services: it is for them to judge. Write down now the number of the emergency services in your country and that of its suicide prevention line, which is often free, answers day and night and also takes calls from parents; in some countries, it can be reached by text. Section 8 sets out these situations in detail. Allow fifty minutes to read.

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1. Before you begin

It is an evening in June. It is hot, and your fourteen-year-old daughter is still wearing her hoodie. As you hand her a glass, you see the sleeve ride up: marks on her forearm, some recent, others older. She yanks the sleeve back down, says it was her friend's cat, and leaves the room.

Or it is your fifteen-year-old son, who comes home for the third time this month with the back of his hand in a bad way, "on a wall, just messing about". Or it is the school nurse who rings you one Tuesday morning, in a voice that is a little too gentle.

You felt afraid, then angry, then ashamed of that anger. You are wondering whether your child wants to die, and whether it is your fault.

Three things, straight away.

Most often, this act is not a suicide attempt: it is a way of soothing an inner pain that has become unbearable. Most teenagers who hurt themselves describe a rapid relief from an emotion they could no longer bear. It is not a whim, and the word manipulation does not fit it: these acts often stay hidden, above all from adults.

That does not make it harmless, and suicide risk must always be checked. Self-harm is one of the clearest risk factors for suicide that we know of, that is, one of the things that, across a large number of young people, most clearly signals an increased risk, even when the teenager does not want to die at the moment they hurt themselves. Nobody can guess what they are thinking by looking at an injury: so you ask them, and asking does not put the idea in their head.

How you react in the first few days matters, and what helps is not what fear dictates. Fear pushes you to punish, to search their things or to promise to tell no one. What helps is simpler and harder: treating the injury, talking without judging, not promising secrecy, making the home safe and looking for help.

2. What we call self-harm

A simple definition

We speak of self-harm when a person deliberately and directly hurts their own body: they cut themselves, burn themselves, hit themselves, scratch themselves until they are injured, or stop a wound from healing. The American psychologist Matthew Nock, in a landmark review published in 2010, reserves this term for injuries inflicted without any intention of dying, which are the most common form.

The 2022 British guideline, written by the National Institute for Health and Care Excellence, the body that sets good-practice recommendations in the United Kingdom and is known by its acronym NICE, uses a broader meaning: any intentional injury or poisoning, whatever the apparent intention. This guide follows that choice, because at the moment of discovery you do not yet know what the intention was.

What it is not

A piercing or a tattoo is not self-harm, and risk-taking behaviour is not self-harm in the strict sense, even though it can signal the same distress. Pulling out your hair or picking at your skin out of habit, to calm a tension rather than to hurt yourself, is a different problem, to which our guide Pulling out hair, picking at skin: taking back control is devoted. Finally, in some autistic children or children with an intellectual disability, repetitive behaviours such as banging their head call for a specialist assessment; the NICE guideline in fact excludes them from its scope.

A behaviour, not an illness

Self-harm is not a diagnosis. It is a behaviour, which can go along with depression, an anxiety disorder, the aftermath of trauma or an eating disorder, or appear during a period of distress with no other disorder. An Australian study that followed almost two thousand adolescents into adulthood showed that those who had depressive or anxiety symptoms were almost four times more likely to start harming themselves. Looking for what is going on underneath is therefore part of the treatment.

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What the rest contains

3. A common behaviour, and most often a hidden one
4. What the act is for
5. The link with suicide, stated accurately
6. What research shows, and what it does not establish
7. What keeps the problem going
8. The day you find out: the first few hours
9. Asking about suicide
10. Making the home safe without turning it into a prison
11. Not watching so closely that you crush their privacy
12. The weeks that follow: talking, understanding, replacing
13. Treatment: who to turn to, and what works
14. School
15. Social media, friends and contagion
16. Brothers and sisters
17. Your own emotions, and how to keep going
18. Particular situations
19. When to seek help, and who to turn to
20. The first four weeks, step by step
21. Frequently asked questions
22. Key points
23. Sources and foundations

Frequently asked questions

My teenager says it's nothing, that they've got it under control. Should I believe them? Believe them when they describe what they feel, but do not let them decide on their own what happens next: many teenagers play things down, out of shame or to protect you. An act of self-harm warrants a medical opinion within the next few days, and the question about suicide must be asked even if they say they have it under control.

Are they doing it for attention? Rarely in the sense people mean. These acts are often hidden, above all from adults, and the most common reason is to bring down an unbearable emotion. When an act also serves to show distress, that distress is real.

Won't talking to them about suicide put the idea in their head? No. The studies that have examined this question, including a trial carried out in American high schools, find no increase in suicidal thoughts among young people who are asked the question.

Do we have to go to the emergency department every time? Not for every superficial injury, but always in the situations in section 8, in particular after a suicide attempt, even if the injury looks minor, and for any medication overdose, even if they say they feel fine. Otherwise, a medical opinion in the following days is enough, or the same day if they say they are thinking about suicide.

Should I ask them to show me their arms regularly? No. Inspections humiliate and teach them to hide. Instead, agree on a time each week to take stock, and ask them to show you an injury when there is one, so that it can be treated.

Should I confiscate their phone? Not as the main measure, because it also cuts them off from their friends and pushes them towards hidden accounts. The phone outside the bedroom at night and a non-judgemental conversation about what they see online are more useful.

Is it my fault? Self-harm most often arises from several factors combining, and looking for someone to blame helps neither you nor your child. Your role concerns what comes next: making the home safe, reacting calmly, staying available and supporting treatment.

How long will this last? It cannot be predicted for any one teenager. Most self-harm in adolescence stops with time, and its frequency falls markedly at the end of adolescence. A new act during treatment is common, even with the best treatment, and does not mean that all is lost.

They refuse to see a psychologist. What can I do? Go to a consultation on your own to get advice, keep the connection going, suggest a smaller step, such as the family doctor they already know, and let them choose whatever can be left to their choice. Keep the home safe. In immediate danger, their refusal does not stop you from calling the emergency services.

Their friends are harming themselves too. Is it contagious? Contagion does happen in adolescence, within a group of friends or a school. The aim is not to cut off these friendships, but to talk about them with your teenager, to encourage them to alert an adult if a friend is in danger, and to stay attentive.

self-harmcuttingteenagerparentssuicide riskemergencymedication overdosesafety plandialectical behaviour therapyschoolsocial mediasiblingsemotion regulation

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