Causes of Self-Harm 

Common causes for self-harm for both neurotypical and neurodivergent young people include:

• Underlying mental health conditions, such as anxiety and low mood
• Struggling with stress and/or worries
• Experiencing/having experienced trauma or difficult experiences (like a relationship breakdown, job loss or illness)
• Being around other people who self-harm

Neurodivergent young people often have additional reasons they may be more likely to self-harm. Differences in how they experience daily life and additional challenges can mean some neurodivergent children and young people aren't as accepted or can be misunderstood. This can lead to rejection, isolation and loneliness as possible triggers for self-harm. Other reasons can include:

• Sensory differences - trying to regulate or manage their sensitivity to light, sounds, texture and touch
• Understanding their emotions - having difficulty recognising, managing and regulating their feelings
• Transition - extra stress around changes in school, work, or home life
• Co-occurring mental health conditions - some neurodivergent young people have an increased likelihood of experiencing anxiety and low mood

Self Injurious Behaviour

Some neurodivergent young people hurt themselves in various ways, like banging their heads on surfaces, biting their hands or pulling their hair. This can be known as self-injurious behaviour and can be an attempt to regulate themselves, express discomfort or communicate a particular need. 

My Child is Self-Harming - What do I do?

If you have just discovered your child is self-harming you probably feel confused, scared and upset. You may not be sure what to do next. It can be a good idea to give yourself a few minutes to breathe slowly and feel calm before you react. Being as calm as you can, will help you and your child.

You will probably have lots of questions and want your child to promise to stop. You might want to remove anything they might use to hurt themselves.

However, taking their coping strategy away before they have been able to develop new healthy ways to manage feelings may make things harder for your child. Ask your child what they think would help, you can do this by:

• Finding somewhere quiet and calm to talk to reduce their sensory input
• Giving your child time to talk about what has been happening, and time to process what you are saying back to them
• Give them other ways to communicate their feelings if they don't feel able to talk, for example using drawings, journalling, writing music lyrics or picture cards 
• Consider using emotion games, and cards that help to teach your child different emotions

Many people who self-harm will say they feel embarrassed and ashamed about what they are doing. Reassuring them that it is not uncommon and they can get better, will be really helpful to them. If your child feels they can talk to you, you will be more able to keep them safe.

Ways to Cope

Help your child to come up with other things to try when they feel the urge to self-harm:

• They could try and distract themselves with colouring, listening to music, writing, poetry, art, watching a film together or going for a walk.
• Let them know they can come to you and you will help them through the dark moments. Be with them and help them try breathing exercises to relax until the urge passes.
• Encourage them to avoid websites that ‘normalise’ self-harm.
• Make sure they know basic wound care - how to keep it clean and when to seek further medical support.
• Eating well, resting and getting exercise will all help them build their strength and improve wellbeing.
• Look at a well-being action plan together, or they may prefer to look alone.
• Encourage your child to explore neuroaffirming websites, articles or social media which tackle the stigma of neurodivergence and help them recognise their strengths.

Remember to take care of yourself too. It is not easy to support your child when they are struggling with self-harm. Talk to trusted family and friends. Use relaxation techniques and care for your own health and well-being.

Getting More Help

When people are self-harming it is always a sign of emotional distress that needs support. Your child should see their GP for an assessment of what might help them most. Talking to your child’s school can help widen your child’s support network too.

Letting other people know will help you and your child get the support they need. They may want you to be there for support or find it easier to talk without you there – ask them what would help the most.

If you are worried that your child has injuries needing immediate medical attention call 111 or 999. The NHS give more information about seeking urgent help.

If you cannot make voice calls, you can now contact the 999 emergency services by SMS text from your mobile phone. Emergency SMS is part of the standard 999 service which has been designed specifically for people with hearing loss or difficulty with speech.

Find out more about mental health advice and support available

Make a Self-Soothe Box

Self-soothe boxes can be a useful way for neurodivergent children to cope with difficult feelings. The boxes contain items which help to distract them from wanting to self-harm.

You will need a small container, such as a box or a bag, to put your child's items into. You can help them choose which items they want to keep in the box - it can be helpful to have items relating to each of the different senses, to promote an overall feeling of calm.

Items which trigger positive memories, such as photographs or a letter, are very useful - use whatever works well for your child.

Here are some ideas of items you could use for the different senses:

Sight - photographs, torch, sand timer, mirror, drawings

Touch - stress ball, string of beads, nail varnish, playing cards, wind-up torch

Sound - playlist of songs which help them feel calm, headphones, noise cancelling headphones, ear plugs, recording of a repetitive sound

Taste - strong mints, chocolate, sweets, snacks, flavoured water/juice

Smell - perfume/aftershave, scented candle, dried herbs/spices, essential oils

Mental Health Safety Planning

Self-harming and suicidal thoughts will pass, but being prepared to manage these thoughts when they happen can make a lot of difference to you and your family. 

A safety plan is a way to think about what or who your child might need to keep themselves safe and give them easy access to get support when they need it most. Think of it as a list for:

• What to do
• Safe places to go
• Ways to safely distract themselves
• People who can help them

Their plan can look however they want it to, whether it's on paper or in their phone, but a good plan will have quick glance information of support available and reminders of what is most important to them. 

Find out how to write a safety plan

Talking to your young person about self-care and support while they are not in crisis can help you to understand what they need and how future crises can be handled. Asking your child to share their plan with you will help them to better communicate what they need if they are unable to explain during a crisis. Take some time with your child when they are feeling a little better to:

• Intentionally plan
• Identify support networks and people to contact
• Brainstorm acts of self-care
• Build skills needed to support your child so when a crisis comes you don't have to start from scratch

Above all, remind your child that it's always okay to ask for help when they need it. 

Shelf Help Books

Books about mental health for 13 to 18 year olds, with advice and information about issues like anxiety, stress and OCD, bullying and exams.

All Shelf Help books can be reserved for free from any Norfolk library, or online. The books are available to borrow for up to six weeks.

Suggestions:

• The Parent's Guide to Self Harm: what parents need to know by Jane Smith
• Healing the Hurt Within: Understand Self Injury and Self Harm, and Heal the Emotional Wounds by Jan Sutton
• Life After Self Harm: A Guide to the Future by Ulrike Schmidt & Kate Davidson
• The Rainbow Journal: For Young People who Self-Injure by Catherine Lucas
• The Self Harm Help Book by Louis Arnold & Anne Magill

Self-harm Policy

Click to view the sample self-harm policy for secondary schools, developed with input from young people, parents and school staff.

It has been funded by Public Health and approved by the Norfolk Safeguarding Children's Partnership.

Health Uncovered Podcast

Health Uncovered is a series of podcasts that aims to get young people in-tune with their health and wellbeing. The series is hosted by BBC Radio One presenter Cel Spellman and features young people and health professionals from our Norfolk Healthy Child Programme.

Life isn't always easy - and young people across the country have been helping us explore the issues that they’re facing today. From online bullying to sexual health, body image to mental health. They've been asking the questions you want to hear answered, joined by the health professionals that help young people, like school nurses and mental health specialists, to provide solutions, support and understanding.