When a Young Person Self-Harms: Responding With Care and Connection

Finding out that a child or young person is hurting themselves can bring a rush of emotions. You may feel frightened, confused, or unsure what to say. You may wonder how you missed the signs or worry that your first response will make things worse.

Take a breath. You do not have to understand everything immediately to offer a caring response. Start by checking their safety, listening, and helping them connect with support.

At the Center for Suicide Awareness, we want families to know that self-harm deserves compassionate attention. A young person who is struggling needs to know that help is available and that sharing what is happening will be met with care.

Understanding what self-harm may mean

Self-harm involves intentionally hurting oneself. For some young people, it becomes a way of responding to overwhelming emotions, numbness, stress, or a feeling of losing control. Any temporary relief does not resolve the underlying pain, and injuries can have serious consequences.

Self-harm does not always involve an intention to die. However, self-harm and suicidal thoughts can occur together, and self-harm is associated with an increased risk of suicide. Never assume you know a young person’s intentions from the appearance of an injury. Both their physical safety and emotional well-being need attention.

Their reasons may be difficult to explain, even to themselves. Approach the conversation with curiosity rather than assumptions about what they are feeling or why they are doing it.

Notice changes without jumping to conclusions

Possible signs include repeated unexplained injuries, attempts to conceal wounds, withdrawing from others, or expressions of hopelessness or worthlessness. These signs can have different explanations, and no single behavior confirms self-harm. They are reasons to check in with care.

You might begin with: “I’ve noticed you seem to be having a hard time, and I care about you. Can we talk about what’s been happening?”

If you have noticed an injury, be gentle and direct: “I noticed an injury, and I’m concerned. Can you tell me about it?”

Choose a private setting when possible. Avoid making the conversation an interrogation or demanding that they explain everything at once.

Let your first response communicate care

If a young person tells you they have been self-harming, acknowledge the trust it took to share it.

“Thank you for telling me. I’m glad you let me know.”

“I care about you. We’re going to get support together.”

Listen without blaming, threatening, or describing the behavior as attention-seeking. Avoid asking them to stop “for you” or relying on a promise that it will never happen again. Focus on what they are experiencing and the help they need.

You can acknowledge their distress while being clear that their safety matters: “I hear that things have felt overwhelming. I want to help you find ways to get through those feelings safely.”

Respect their privacy, but do not promise secrecy when safety is involved. Explain who needs to help and include them in that conversation whenever possible.

Check safety and connect with professional help

First, assess whether an injury needs medical attention. Serious injuries, bleeding that will not stop, or possible poisoning or overdose require immediate medical help. If you are unsure how serious an injury is, seek medical advice promptly.

Ask directly: “Are you thinking about suicide?” Asking this question does not put the idea in someone’s mind. It gives them an opportunity to tell you what they are experiencing.

If they report suicidal thoughts, seek urgent professional guidance. If they have acted on those thoughts, have an immediate plan or intent, or cannot stay safe, stay with them and get emergency help. Call 911 in a life-threatening emergency. Secure medications, firearms, and other items that could be used for harm when you can do so safely.

Even without suicidal thoughts, self-harm warrants professional support. Contact their pediatrician, health care provider, or a qualified mental health professional. You do not need to wait for injuries to become more severe.

Build a plan for difficult moments

• Work with a professional and the young person to develop a safety plan that identifies warning signs, supportive people, coping strategies, and steps to take when urges increase.
• Depending on the young person’s interests and needs, safe coping options may include:
• Asking a trusted person to sit with them or talk.
• Drawing, journaling, listening to music, or engaging in a familiar hobby.
• Spending time with a pet or holding a comforting object.
• Taking a gentle walk with someone or trying slow breathing.
• Moving to a shared space where support is available.

Where fidgets may fit

Some young people may find a soft textured ball or handheld sensory roller helpful for keeping their hands occupied, focusing on a comfortable sensation, or grounding themselves during an overwhelming moment. The textured balls and rollers pictured with this article are examples of this type of tool; individual products vary in softness and firmness.

A young person might gently squeeze a soft ball or explore its texture with their fingers while talking with a trusted person. Offer it as a choice: “Would holding something help while we talk?” Let them tell you whether it feels useful or uncomfortable.

The purpose is comfortable sensory input, not pain. Choose soft, flexible textures and gentle pressure. Avoid sharp or rigid spikes, pressing hard enough to hurt, or anything that irritates or damages the skin. Products marketed as “pain” fidgets are not automatically a safe choice.

Fidgets are optional coping tools, not a treatment for self-harm or a replacement for connection and professional care. Include them in a safety plan only if the young person finds them helpful, and ask their care team about suitability when they have sensory differences, skin concerns, or other medical needs. For younger children, choose age-appropriate items without small detachable parts.

These activities can offer support in a difficult moment; they do not replace treatment or urgent help when safety is at risk. Avoid strategies that deliberately cause pain or injury.

For young people with disabilities, developmental differences, or complex health needs, adapt the plan to their communication, sensory, and medical needs. Involve professionals who understand their individual situation.

Keep showing up

Continue checking in after the first conversation. Make room for ordinary time together as well as discussions about safety. A young person should know that your relationship includes their interests, strengths, and everyday life.

Parents and caregivers need support, too. Talk with an appropriate professional or trusted support person while protecting the young person’s privacy. You do not have to manage this alone.

If you are a young person reading this, you deserve care. Tell a trusted adult or health professional what is happening, even if you need to write it down or show them this article to begin.

For young people, parents, and caregivers who need someone to listen, HOPELINE™ is a free, confidential, 24/7 Emotional Support Text Line.

Text HOPELINE™ to 741741.

Hope and help are just a text away.™

Learn more at www.centerforsuicideawareness.org.

More Connection. Less Isolation.™