What is self-harm?

Self-harm is defined as the act of someone hurting themselves intentionally (on purpose).

Most people who self-harm aren’t attempting suicide. Self-harm can be a way to express or control distressing thoughts or feelings.

Self-harm can cause more damage to your health and safety than you may have intended.

What signs suggest someone may be self-harming?

Self-harm may go unnoticed by others. Many people who self-harm do so in private and may not seek help.

Self-harm may include behaviours such as:

• cutting, burning or hitting yourself
• participating in risky behaviour
• abuse of drugs or alcohol

Signs that someone may be self-harming can include:

• changes in mood
• being secretive
• avoiding situations where you have to expose your arms or legs
• strange excuses for injuries
• withdrawing from usual activities

Why might someone self-harm?

There are many reasons people self-harm, and the reason for each person is different.

Self-harm behaviour may be a way for someone to manage distress or painful feelings. It may give short-term relief from these feelings.

Some people who self-harm may only do so once, whereas others self-harm frequently and for many years.

For most people, the feeling of relief after self-harming is only short term. This can result in a desire to self-harm again. Self-harming behaviour can occur in anyone at any age, including young people.

Reasons for self-harming may include:

• dealing with distressing feelings and memories
• communicating the need for support
• as an outward sign of inner pain
• self-punishment for feelings of guilt or shame
• loneliness

Triggers for self-harm may include:

• bullying
• school or work problems
• relationship problems
• low self-esteem

People living with mental health concerns or those who have experienced physical, emotional or sexual abuse are at increased risk of self-harming.

How to get help if you or someone you care for self-harms

If you self-harm, it’s important to get help.

Try to find supportive people who:

• you feel comfortable with
• you can talk to
• will listen without judgement

If you have a friend or a family member you can trust, reach out to them to help you.

Healthcare professionals who can help include your doctor, as well as:

• counsellors
• psychologists

Seeking help early can reduce the damage caused by self-harm and decrease your risk of self-harming in the future.

How can I support someone that I care about who is self-harming?

If you think someone you care for is self-harming, it is important that you:

• offer support
• encourage them to get professional help

Continue the conversation about their mental health by checking in with them to see how they are going.

If you are concerned for someone’s welfare and want to tell a healthcare professional, it’s important to tell the person first. Reassure them that:

• you have their best interests in mind
• you care about them
• your intentions are to help keep them safe

While it’s important to be there for the person that you care about, it’s a lot to manage on your own. Consider if you need to get support or advice from a healthcare professional or helpline.

How is self-harm treated?

There are different approaches to treating self-harm. Your doctor, counsellor or psychologist will work with you to develop a treatment plan.

Psychological therapies can help you understand why you self-harm. They can also give you tools and techniques to help you cope with any challenging thoughts and feelings.

Psychological therapies for self-harm may include:

• cognitive behaviour therapy
• dialectical behavioural therapy
• mindfulness
• problem solving therapy

What techniques can be used as distractions from self-harming?

Techniques that work as alternatives and distractions from self-harm can help relieve distress in the short-term. But remember, it’s important to seek medical help to stop self-harming behaviours.

Examples of alternatives to self-harm that can relieve distress in the short term include the following.

• Distract yourself by doing an activity that you enjoy such as reading, art, journaling, listening to music or going for a walk.
• Divert to an activity that will not cause injuries, such as holding ice cubes in your hands, wearing a rubber band on your wrist and snapping it when you feel you need to, or punching a pillow.
• Doing some deep breathing and relaxation exercises.

You may want to copy your list of alternative activities onto a piece of paper or into your phone. This way you have it when you need it.

Complications of self-harming behaviour

Self-harming behaviour can have very serious complications, such as an increased risk of serious physical harm or accidental suicide. These complications can occur when you cause more damage than intended.

People who repeatedly self-harm may become suicidal or feel hopeless.

Resources and support

It’s important you reach out if you need to talk to someone. Support and information are available from:

• Head to Health — for advice and to get connected to local mental health services, you can call 1800 595 212. Check the operating times.
• SANE Australia — you can phone the helpline on 1800 187 263
• Lifeline — call 13 11 14 for 24-hour crisis support or chat online
• Suicide Call Back Service — phone 1300 659 467 or chat online
• Kids Helpline — WebChat or call1800 551 800
• Beyond Blue — call a counsellor on 1300 22 4636
• MensLine Australia — phone and online counselling, call 1300 78 99 78
• Headspace — the National Youth Mental Health Foundation

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.

If you would like to learn how to support people struggling with the challenges of self-harm and mental illness, consider doing a mental health first aid course.