Understanding Self-Harm in Children and Teens

What is self-harm?

Self-harm, also called nonsuicidal self-injury (NSSI), happens when someone intentionally hurts their body without wanting to die.

Examples of self-harm may include:

• Scratching
• Burning
• Pulling out hair
• Cutting
• Causing bruises

For example, a child may cut themselves or pull out their eyelashes on purpose to deal with intense emotions. A child accidentally burning themselves or piercing their own ears for social or cultural reasons would not be considered self harm or NSSI.

While self-harm is scary for families, it’s important to know recovery is possible. Many children fully recover by learning healthier ways to cope.

Who is at risk of self-harm?

Self-harm can affect children of all genders, sexual orientation, race, ethnicity or background. It may begin as early as age 7, but it is most commonly seen in ages 12 to 15 or during the college years.

Common risk factors include:

• History of trauma
• Feeling isolated or disconnected from others
• Substance or alcohol misuse
• Depression and/or anxiety

Why do kids self-harm?

Self-harm may be used to escape negative emotions, “calm down” and feel a temporary sense of relief. When physical pain lessens or stops, it can trick the brain to feel less emotional pain as well.

This “relief” does not last and often leads children to repeat their injuries to experience it again.

With support and practice, children can learn how not to self-harm by using healthy coping strategies for handling difficult emotions. Children and teens who self-harm should also work with a therapist to find new ways to handle challenges.

What are the signs of self-harm?

Caregivers may notice:

• Unexplained cuts, burns, scratches or bruises
• Wearing long sleeves even in warm weather
• Avoiding activities where injuries may be seen
• Increased isolation
• Changes in mood
• Difficulty managing emotions

Is self-harm the same as a suicide attempt?

NSSI does not always indicate someone is suicidal, in fact, over half of those who report NSSI do not report suicidal thoughts or behaviors.

Many children and teens who self-harm are using it as a way to deal with emotional pain. Self-harm should be taken seriously. If your child is self-harming, it’s important to understand the why they are harming themselves to determine if they are also having thoughts of suicide.

If your child is talking about wanting to die, expressing hopelessness or showing signs of suicidal thoughts, seek immediate help by contacting 988, calling emergency services or going to your nearest emergency department.

When should I seek help for self-harming?

If your child is self-harming, professional support is important.

A mental health professional can help your child:

• Practice new coping strategies
• Identify triggers
• Learn healthy ways to navigate distressing situations

How can I support a child who is self-harming?

If your child says they are self-harming, remain calm and listen without judgement. Calm, open conversation is a major protective factor for NSSI. Take a deep breath and let them know you want to understand what is happening. Remember, taking time to understand allows us to provide effective help, it does not mean you agree with the behavior.

• Start by thanking them for sharing and that you are glad they came to you. Let them know they are not alone.
  • For example, you might say something like “I appreciate that you’ve told me this, it must have been difficult to share that. It sounds like things have been really painful for you and you’re trying this to feel better. I care about you and want you to have other options to feel better.”
• You may be worried and have a lot of questions. Try to limit questions to avoid overwhelming them.
  • Consider saying something like, “Can I ask you a few more questions about why you’re doing this and how you feel afterward?”
  • Focus on events or situations that may trigger self-harm, how they self-harm, and what they felt like afterwards
• Avoid reacting with anger or shame, as they may be reluctant to share them with you in the future.
• You can help by paying attention to the emotions that they struggle to cope with. Name feelings and acknowledge them, without labeling them as “good” or “bad.”
• Suggest options that allow your child to have input on how the conversation happens. Such as “would you like to sit on the couch to talk or go for a walk?”. If they don't want to talk right then that is OK! Try doing an activity together like getting ice cream, playing a game, or watching a movie. Sometimes the best conversations happen when we are doing something else and revisit the conversation at a different time.
• You can also work with them on how to handle self-injury urges ahead of time and remind them that they are not alone on this journey.
• Seek support from a professional. Call the 988 Suicide & Crisis Lifeline for free, confidential support from trained professionals or talk to your doctor. If the injury requires medical attention, call 911 or go to your local emergency room.

And finally, take care of yourself! The emotions you are feeling are typical and understandable. Take the time to identify your support system, your own healthy coping skills and connect with a mental health professional if you believe it would help.

It will take time, but recovery from self-harm is possible with consistent effort and motivation.

References

Cornell University. College of Human Ecology. Self-Injury and Recovery Resources. Cornell University. Accessed July 2026.

Hodgson CG. (February 12, 2026). Youth Self-Harm: The Role of the Caregiver. Info About Kids. Accessed July 2026.