Supporting someone who self-harms

Stay calm and non-judgemental, and listen more than you talk. If you feel panicked, it’s okay to say, “I need a moment, but I’m here and I love you.”

People often hide self-harm because they fear upsetting others or being punished. A calm response makes it more likely they will come to you again.

If an injury needs medical attention, take them to a doctor or hospital. Injuries can get infected without treatment. If an injury is serious or their life is at risk, call 911.

Keep your tone gentle and practical: “Let’s get this looked at so it heals properly.”

Punishing someone for self-harm, or taking away their independence as a threat, increases shame and pushes it further into hiding. Health guidance is clear there is no place for punitive responses.

Pressuring someone to stop, or making them promise never to do it again, rarely works. Self-harm is a coping strategy, and stopping usually means first learning other ways to cope.

If they can’t keep a promise, they may feel they have failed you and hide it more. Focus on the feelings underneath and on getting support together.

Gently ask if they have had thoughts of ending their life. Honest, loving questions are far more likely to help keep someone safe than to put the idea in their head.

You could say: “Sometimes when people are hurting this much, they think about suicide. Have you had thoughts like that?”

Be open-minded, avoid assumptions, offer reassurance, and show that you are there to help without judgement.

You could say

• “Thank you for telling me. That took courage.”
• “I love you, and nothing changes that.”
• “This is hard for me to talk about, but I want you to be healthy and safe.”
• “What’s been going on for you lately?”
• “How would you like me to support you?”
• “We’ll figure this out together.”

Avoid insulting the person, dismissing their feelings, or calling it attention-seeking. Don’t brush it off as “just puberty” or “a phase”.

Try not to say

• “Why would you do this to me?”
• “You’re just doing it for attention.”
• “You have nothing to be upset about.”
• “Promise me you’ll stop right now.”
• “Show me.” (Let them decide what to share, and leave checking injuries to a health professional.)

Focus on listening and understanding rather than solving everything at once. Don’t bombard them with questions.

Listening tips

• Reflect back what you hear: “It sounds like you’ve been feeling really alone.”
• Let silences happen
• Notice their positive qualities and say them out loud
• Remember that even small amounts of self-harm can mean a lot of pain

People who self-harm often deny it or get upset at first. That is normal. Raise it again during a calmer moment.

If you reacted in a way you regret, it’s okay to come back and say: “I was scared and I didn’t handle that well. I want to try again.” Repair builds trust.

Avoid starting the conversation during an argument or when everyone is stressed. A quiet walk or a drive can feel less intense.

Some teens find it easier to write or text about how they feel. Offer that option.

Work together to notice triggers and pressures, and reduce them where possible. That might mean talking to school about workload, addressing bullying, or easing family stress.

A mood diary can help them notice when urges build and what they are feeling.

Stay involved and check in often, but try not to make them feel watched or followed. Constant checking can feel like punishment and may damage trust.

Gentle check-ins

• “How’s today on a scale of 1 to 10?”
• A regular one-on-one activity you both enjoy
• Leaving a kind note or snack
• Agreeing a code word they can use when things feel hard

Share information with trusted people in your child’s life when it helps, while respecting their privacy. Talk with them about who needs to know and why.

Allow private one-on-one time with their doctor. Teens are often more open when a parent isn’t in the room.

Regular meals, enough sleep (about 8 to 10 hours a night for teens), exercise and time with loved ones all help.

A family media plan can protect sleep and reduce isolation. Your own screen habits matter too, because they shape how much time you have to connect.

Make a doctor’s appointment even if your child resists. You can get advice yourself even if they won’t come with you.

For adults, you can encourage them to see a doctor or a listening service, and offer to go along. Respect their right to make their own decisions, while arranging medical help when it’s needed.

Talking therapies like CBT and DBT can help after self-harm. Sessions can be in person, online or by phone, and can involve family or a partner.

For teens, DBT-A has the best evidence for reducing repeated self-harm. It often includes parent skills groups and phone coaching for parents as well as teens.

Looking for and treating any other struggles, like depression, anxiety, ADHD, trauma or eating difficulties, is important alongside the self-harm itself.

Care should focus on the person’s own circumstances, strengths and needs, and be compassionate and collaborative.

Encourage the person to build trust with their therapist or counselor. It can take a few sessions to feel comfortable.

Families and carers should get clear information about self-harm, treatment options and support. It’s okay to ask the care team, “How can we help at home?”

Talk with your child first about who at school should know and what they’d like shared. Share information with trusted people, while respecting their privacy.

Things to ask school about

• A trusted adult or counselor your child can go to
• A quiet place to take a break when things feel too much
• Easing workload or deadlines during hard times
• How bullying will be handled
• Who will contact you if they are worried

Watch for changes like withdrawal, low mood, anger, or covering up even in warm weather. If a student confides in you, stay calm, listen without judgement, and thank them for telling you.

Follow your school’s safeguarding and mental health procedures, and connect the student with the counselor or nurse. Be honest that you can’t keep it secret, but that you will help them through what happens next.

If a friend tells you they self-harm, listen, let them know you care, and encourage them to talk to a trusted adult or doctor.

You don’t have to keep a secret that worries you. Telling a trusted adult is caring, not betrayal. Look after yourself too.

Siblings often notice more than adults think. Give them simple, age-appropriate information, with the struggling person’s privacy in mind: “Your brother is having a hard time and getting help.”

Make time for one-on-one attention with each child, and let them know their feelings matter too.

Agree together on how you will respond, so the person gets a calm, consistent message. Try not to blame each other.

If you are supporting an adult partner, respect their choices and independence, while encouraging professional support.

Keep up family meals, outings and simple fun. The person is more than their struggle, and normal life reminds them of that.

The Families guide has more ideas for staying connected through hard times.

Parents should not be blamed for a child’s struggles, and self-harm does not make you a bad parent. Seek shame-free support for yourself.

You may wonder “What did I miss?” Remember that self-harm is often carefully hidden. What matters now is how you respond, and you’re already doing that.

Check in with yourself, ask for help when you need it, and talk to someone you trust. A parent or carer support group can help you feel less alone.

Your own therapist or counselor can be a big help. You can also call or text 988 for support as someone worried about a loved one.

Short walks, sleep, meals, prayer, music or time with a friend all help refill your energy. Share the load with other trusted adults where you can.

The Family caregivers and Self-care basics guides have more ideas for looking after yourself while caring for others.

Setbacks are common and don’t mean failure, for them or for you. Celebrate small steps, like reaching out for help or trying a new way to cope.

Trained counselors can help you work out immediate steps to keep someone safe. You can call about yourself or about someone you’re worried about.

A trained volunteer crisis counselor texts back. This can be easier for young people who don’t want to talk out loud. Message and data rates may apply.

Crisis counselors who understand the experiences of LGBTQ+ young people, available any time.