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Signs and Risk Factors of Self-Harm in Youth

This blog was originally published in May 2018 and was updated in January 2022 to provide new information and data.


Self-harming is when a person damages or injures their body on purpose. Often someone does this because they think it will help relieve emotional pain while it’s inflicting actual physical pain. While there can be a link between self-harm and suicidal thoughts, that is not always the case. Often someone self-harming does not want to die. All cases of self-harming should be taken very seriously as the person involved is in distress.

A recent study of 65,000 high school students in the United States found that 18% of adolescents reported at least one occurrence of self-harming, including one in four girls and one in ten boys. Due to the stigma surrounding self-harm and some people’s reluctance to seek help or report it, actual rates of self-harm might be higher than this.

A person’s arms, legs, and front torso are the most common areas that youth tend to self-harm, but they may also use other parts of their body. Some of the most common methods of self-harm include, but are not limited to:

  • Cutting or deeply scratching their skin
  • Piercing their skin with sharp objects
  • Burning their skin
  • Hitting or punching themself
  • Banging their head or other body parts against hard or sharp surfaces
  • Pulling out hair
  • Picking at existing wounds
  • Swallowing objects that will harm their internal organs or cause life-threatening damage

mental health assessment

Why Do Youth Self-Harm?

The reason a child or teen chooses to self-harm is not always known. Often it is linked to a traumatic experience or it may stem from their struggle with another disorder like depression, anxiety or autism spectrum disorder. Many other difficult emotions or experiences may lead a youth to self-harm, such as the inability to express their feelings or a loss of control over their life. They might see self-harming as a way to cope with difficult feelings and relieve emotional pain, but self-harm is not healthy behavior and should be viewed as a cry for help.

Click here to learn about more reasons a child or teen might self-harm.

Youth at Risk for Self-Harm

Children and teens from all walks of life, backgrounds and demographics can be at risk for engaging in self-injury. A child or teen might be at a higher risk if they are:

  • Being bullied or bullying others
  • Struggling with low self-esteem, feelings of worthlessness
  • Diagnosed with another behavioral health disorder
  • Unable to maintain healthy relationships or make connections
  • Not performing well at school or struggling with a learning disability
  • In the LGBTQIA+ community, especially if they have experienced rejection from family or friends based on their sexual orientation and/or gender identity
  • Struggling to cope with a traumatic experience such as abuse, loss of a parent, a physical health diagnosis (i.e., cancer) or witnessing violence (visit www.kvchospitals.org/trauma for more examples)

In addition to the physical harm that results from self-injury, there are many other risks and negative impacts on a child’s life. Self-harm can cause feelings of shame, sadness, guilt or loneliness which can lead a youth to make other unhealthy choices such as using drugs or alcohol. Youth who self-harm are also more likely to experience untreated depression, enter into unhealthy or harmful relationships and have suicidal thoughts.

Warning Signs of Self-Harm

It’s important to pay attention to a child or teen’s words and behaviors. They may struggle to talk about their feelings. By paying attention to what they are saying or doing you can ask them questions to help start dialogues about what is going on in their life. Youth often hide self-injuries but there are warning signs you can watch for. These include, but not limited to:

  • Several or frequent cuts, scratches, bruises, bite marks or other wounds
  • Several scars, often in patterns or on the same area of the body
  • Excessive rubbing of an area to make it burn
  • Keeping sharp objects nearby, such as in their bedroom, bathroom or personal belongings
  • Constantly wearing long sleeves or pants, especially in hot weather
  • Frequent accidental injuries
  • Difficulties in interpersonal relationships, connecting with family and friends
  • Behavioral and emotional challenges
  • Acting impulsively or being unpredictable
  • Making statements of feeling hopeless or worthless
  • Increased isolation

What You Can Do to Help

If you believe a child is self-harming, take it seriously and do not ignore it. Ask them what they are feeling and if something has or is occurring in their life that is bothering them. Have judgment-free conversations so that they feel comfortable opening up to you. Listen with compassion and validate their feelings. Here are some steps to take if a youth tells you they are self-injuring:

  • Seek professional help. It’s important to have a professional examine the child for an accurate assessment and diagnosis of their physical and mental health. A good place to start can be talking with the child’s primary physician, a school counselor or licensed mental health professional.
  • If the youth expresses thoughts of suicide, call 911 immediately. Take these statements very seriously. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255.
  • Stay calm in front of them. They are often observing how the adults around them react and if you panic, it may cause them more emotional distress. Do not yell, make threats or shame them. Create a safe space.
  • Teach them other ways to self-soothe. Help them find healthier ways to cope, such as making art, going on a run, doing yoga, meditating, or other activities they enjoy and can relieve intense feelings through. Help them create an Emotion Regulation Plan that they can use when they start to notice overwhelming feelings building up.
  • Encourage frequent, open and honest conversations. Ask them how they’re feeling and allow them the time and space to open up as they’re ready. Just letting them know you are there for them to have a judgment-free conversation will build trust.

Treatment for Self-Harming

Self-harm can effectively be treated with therapy and/or medication. It is important to speak with a licensed mental health provider who can perform an assessment and create a care plan. Therapy can help teach youth how to manage difficult feelings so they find healthier ways to process emotions and cope. It also gives them a trusted person they can open up to, free of judgment, to express their life experiences and feelings.

Opening up and talking out loud about the challenges they are experiencing can be an immense source of relief. If the child is diagnosed with another condition like depression, anxiety or obsessive-compulsive disorder, medication may help reduce symptoms that lead to self-harming. Depending on the severity of each child’s behaviors and symptoms, inpatient hospitalization may be needed to help them stabilize and work toward safely continuing treatment in an outpatient setting.

Learn more about self-harm and download a free info sheet to share with others at: kvchospitals.org/selfharm