Any parent who has a teenage son or a daughter has either heard or witnessed 'self-harm' first hand. For parents not only is self harm very concerning but it also leads to significant conflict. They question if they are 'good enough' parents. Are they doing the 'best' for their children.
So what is self-harm? Self harm is when a teenager hurts herself physically. Clinically, the most common forms of self harm I see are cutting, scratching, picking skin, pulling out one's hair, burning one's own skin and ingesting pills.
Why would my son or daughter want to self harm? Many reasons. But the most common I see is anxiety and stress either from school or home. At school stress could happen due to being bullied, not fitting socially, not achieving academic excellence, poor self esteem, relationship issues & gender identity issues. At home, stress could happen due to parental conflicts, conflicts with siblings, financial problems, coming out for kids who identify themselves as gay, lesbian or transgender, abuse and not meeting parental expectations.
Teenagers often report to me that self harm takes away the emotional pain they are suffering and replace it with physical pain which is more tolerable. Some teenagers are venting our anger and frustration towards themselves or others by hurting themselves. For some self harm is ritualistic and for some self harming can make them feel a sense of heightened emotion or experience.
As a parent what should I do or not do? Most importantly, Do Not consider Self harm as merely an 'attention seeking behavior'. It is a genuine problem and a very strong predictor for future suicide. It is often difficult for parents to comprehend the problem. It is better to be concerned, confused and conflicted than ignoring the problem. Do not ignore it. Take Action.
I just saw my child who has self harmed. What do I do?
- If injuries are serious, call your child's pediatrician. If it is after hours or doctor's office is not responding, call 911 or take your child to the the nearest emergency room.
- If the wounds are fresh, provide appropriate first aid like dressing fresh wound.
- Do not over react. It can make matters worse.
- While waiting for the ambulance or on your way to the hospital, ask questions like
- How did it happen?
- Go through the events step by step.
- How did they harm themselves?
- Where did they do it?
- Their feelings at the time of harming themselves
- Is it their first time harming themselves or have they hurt them selves before?
- Have they ingested anything as well like alcohol, pills, drugs?
- At the ER, your child will be evaluated physically and then by a mental health clinician as well.
- Upon discharge from the hospital, they will put into place a plan like having to see a therapist and a psychiatrist.
- Follow the discharge plan as recommended
- At home, implement a safety plan like removing dangerous objects, Ensuring the child is not left alone and Check in with them regularly.
- Inform the school about the recent ER visit or hospitalization and develop a safety plan with the school guidance counselor or psychologist.