Supporting a Young Person Who Self-Harms : Part 2 of 2

In Part 1, we talked about what self-harm is, why young people do it, and the warning signs to look for. If you haven't read that yet, I'd encourage you to start there.

But understanding is only half the journey. Now comes the harder part: what do you actually do?

If you've discovered that someone you love is hurting themselves, you're probably feeling a mix of emotions right now. Fear. Guilt. Anger, even. Maybe a desperate urge to fix it, to take the pain away, to make it stop. All of that is completely normal.

But I need you to hear this: you can't fix it overnight. What you can do is be a safe place. And sometimes, that's everything.

Having the Conversation

This might be the most terrifying conversation you'll ever have. But avoiding it won't make the problem go away. It will just leave your young person feeling more alone.

How to approach it:

Choose your moment carefully. Find a quiet, private time when you won't be interrupted. Don't trap them in front of others or when emotions are already running high. A car journey can actually work well because you're side by side rather than face to face, which can feel less confrontational.

Lead with love, not fear. Start by letting them know you care about them and you're worried. Something like: "I've noticed you seem to be struggling lately, and I love you, and I want to help." Avoid starting with accusations or demands to see their arms.

Listen more than you speak. Your instinct might be to jump in with solutions or to express your own distress. Try to resist. Let them talk. Let there be silences. Sometimes the most powerful thing you can do is simply bear witness to their pain without trying to fix it immediately.

Validate their feelings. Even if you don't understand why they're hurting themselves, you can acknowledge that they're in pain. "It sounds like things have been really hard for you" goes a long way. Avoid minimising ("It's not that bad") or comparing ("Other people have it worse").

Don't make them promise to stop. I know this seems counterintuitive, but demanding they stop immediately can backfire. Self-harm is a coping mechanism. Taking it away without replacing it with something else just leaves them with unbearable feelings and no way to manage them. Focus on getting support, not on stopping the behaviour overnight.

What Helps vs. What Makes Things Worse

What helps:

Staying calm, even when you're terrified inside. Your young person needs to know they haven't broken you.

Making it clear that you still love them, that this doesn't change how you see them.

Asking how you can support them rather than telling them what they need.

Being patient. Recovery isn't straightforward. There will be setbacks.

Keep communication open, even when it's hard.

What makes things worse:

Reacting with anger, disgust, or horror. Even if you feel these things, expressing them can drive your young person further into shame and secrecy.

Issuing ultimatums or punishments. "Stop this or else" doesn't address the underlying pain and can damage trust.

Constantly checking their body or searching their room. This feels invasive and controlling, even if it comes from a place of fear.

Making it about you. "How could you do this to me?" shifts the focus away from their pain onto your reaction.

Dismissing it as attention-seeking or a phase. We covered this myth in Part 1, but it bears repeating: this attitude can be genuinely dangerous.

Why So Few Young People Ask for Help

Remember that statistic from Part 1? Only 15.64% of young people who self-harm ever seek professional help. That means most of them are suffering in silence.

The biggest predictor of whether a young person gets help is whether their family knows. When families are aware, young people are far more likely to access support. But shame, fear of judgment, worry about burdening others, and concern about how adults will react all create massive barriers.

When young people do reach out, around 73% turn to friends or siblings first, not adults. They test the waters with their peers before risking the bigger, scarier conversation with parents or professionals.

This is why your reaction matters so much. If your young person has told you, or if you've found out and they haven't run from the conversation, that's huge. They're trusting you with something incredibly vulnerable. How you respond will shape whether they keep trusting you.

What Protects Young People

But there is also some good news. Research has identified clear protective factors that reduce the risk of self-harm and support recovery. And many of them are things you can actively nurture.

Social support tops the list, with a 45% protective effect. Young people who feel connected to others, who have someone they can turn to, who don't feel alone in their struggles, these young people are significantly more protected. This doesn't have to mean huge friendship groups. Even one trusted person can make a difference.

High self-esteem (38% protective effect) matters enormously. Young people who have a solid sense of their own worth are better able to weather life's storms. Building self-esteem is a long game, but it starts with how we talk to young people, what we praise, and how we help them see their own strengths.

Strong family relationships (35% protective effect) create a buffer against almost everything. This doesn't mean perfect families. It means families where young people feel heard, valued, and safe enough to be themselves.

Healthy coping skills (32% protective effect) provide alternatives to self-harm. These might include creative outlets, physical activity, talking to someone, journaling, or grounding techniques. The more tools in their toolkit, the better.

Mindfulness (28% protective effect) helps them stay present with difficult emotions rather than being overwhelmed by them. Even simple breathing exercises can make a difference.

What Treatment Looks Like

Professional support can make an enormous difference. And the good news is that we have treatments that genuinely work.

Dialectical Behaviour Therapy (DBT) is considered the gold standard for self-harm, with an 87% effectiveness rate. Originally developed for borderline personality disorder, DBT teaches skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. It's practical, structured, and specifically designed for people who struggle with intense emotions.

Cognitive Behavioural Therapy (CBT) is also effective (72%), helping young people identify the thoughts and triggers that lead to self-harm and develop alternative responses.

Family therapy (68% effectiveness) can be invaluable, particularly when family dynamics are contributing to the problem or when the whole family needs support to navigate recovery together.

Mindfulness-based approaches (65%) and interpersonal therapy (60%) also show strong results.

Medication alone isn't usually the answer for self-harm, showing only around 45% effectiveness. But when combined with therapy, particularly for underlying depression or anxiety, it can be a helpful part of the picture. The challenge, of course, is accessing these treatments. NHS waiting lists can be long, and private therapy is expensive. But there are options: school counsellors, CAMHS referrals, online therapy platforms, and charities that offer free or low-cost support. Don't give up if the first door you knock on doesn't open immediately.

The Road to Recovery

Recovery from self-harm isn't a straight line. There will likely be setbacks, moments when old patterns resurface, times when it feels like nothing is changing. This is normal. It doesn't mean treatment isn't working or that your young person isn't trying.

What recovery looks like:

Longer gaps between episodes

Less severe methods when it does happen

Being able to use alternative coping strategies some of the time

Reaching out for help more quickly

Understanding their triggers better

Feeling less shame and more self-compassion

Celebrate the small wins. Every day without self-harm is a victory. Every time they use a healthy coping skill instead is progress. Every honest conversation brings you closer.

A Note on Suicide Risk

I want to address something important. While self-harm is not the same as a suicide attempt, the two are connected. Around 60% of young people who self-harm are at increased risk of suicide attempts. This doesn't mean that everyone who self-harms is suicidal, but it does mean we need to take it seriously.

If your young person expresses thoughts of wanting to die, talks about being a burden, gives away possessions, or seems to be saying goodbye, please seek help immediately. Call your GP, go to A&E, or contact a crisis line. Trust your instincts. It's always better to overreact than to miss something.

Looking After Yourself

Before I close, I need to say something to the parents and carers reading this: you matter too.

Supporting a young person who self-harms is exhausting, frightening, and emotionally draining. You cannot pour from an empty cup. Please make sure you're getting support for yourself too, whether that's talking to a friend, seeing a therapist, joining a support group for parents, or simply making time for things that replenish you.

Your feelings are valid. Your fear is valid. Your grief for the child you thought you knew is valid. You're allowed to struggle with this. That doesn't make you a bad parent. It makes you human.

There Is Hope

I want to end where I began: with hope. Self-harm is serious, but it is not a life sentence. With understanding, support, and the right help, young people do recover. They learn healthier ways to cope with the big feelings that once seemed unbearable. They grow into adults who look back on this chapter as something they survived, something that taught them about their own resilience.

Your love matters. Your presence matters. Your willingness to sit in the discomfort, to keep showing up, to hold space for pain you can't fix, this matters more than any perfect words or perfect responses.

To the young people reading this: you are not broken. You are not too much. You are someone who found a way to survive unbearable pain, and that took strength, even if it doesn't feel like it. There are better ways, and you deserve help finding them.

To the parents and carers: you are not failing. You are here, learning, trying, loving fiercely in the face of something terrifying. That's not failure. That's courage.

You're not alone in this. None of you are.

If you or someone you know is struggling:

Samaritans: 116 123 (free, 24/7)

Childline: 0800 1111 (free, for under 19s)

Young Minds Crisis Messenger: Text YM to 85258

SHOUT: Text SHOUT to 85258

PAPYRUS (under 35s): 0800 068 4141

Self Injury Support: www.selfinjurysupport.org.uk