Every day, hundreds of people contact our Shout mental health text support service about self-harm. In 2022, mentions of self-harm appeared in around 15% of all conversations, predominantly with children and young people.
But what is self-harm, what are the reasons people self-harm and what insight does our Shout dataset give us that can enable us to provide further support to people? In this blog, we explore the findings from our Data Insights team, along with looking at what can be done to help people who are self-harming.
What is self-harm?
Self-harm is commonly described as an intentional act of self-injury or bodily harm. It can take many forms including cutting, scratching or burning the skin, hitting or punching oneself, misusing alcohol and drugs, hair pulling, consuming poisons, and deliberate starvation (anorexia). Less common methods include getting into physical fights, having unsafe sex, and over-exercising to the point of collapse or injury.
What have we learned about self-harm through our data insights at Shout?
Every day, hundreds of people text Shout about self-harm. In 2022, Shout volunteers took almost 110,000 conversations about self-harm, making up over 15% of all conversations.
- More than 60% of those conversations were with teenagers (almost 80% of whom identified as female; and 56% identified as LGBTQ+)
- Indeed, younger texters are far more likely to discuss self-harm: it was an issue in 31% of conversations with texters aged 13 or under, and 27% of conversations with texters aged 14-17
- In 43% of those conversations about self-harm, suicide was also an issue. Emergency services were contacted in around 1 in 10 cases where we felt the texter was at imminent risk of suicide
These insights highlight the concerning demand amongst young people for support with self-harm, in many cases in conjunction with suicidal thoughts and behaviours.
The importance of digital ‘in the moment’ mental health support
Our analyses found that texters who discussed self-harm frequently also described being lonely and isolated. Without having anyone to talk to, many were emotionally exhausted and struggled to manage the overwhelming thoughts and feelings on their own.
In many of these conversations, we saw a cycle of behaviour emerging; pent-up emotions led to distress, which then led to self-harm for relief. Texters described this relief as fleeting, offset by feelings of shame, which spiralled them back to their feelings of distress and urges to self-harm for relief.
“[The volunteer] was lovely in talking to distract me from bad thoughts, feelings and self-harm. Thank you so much.” - Shout texter feedback
This illustrates a loop often associated with self-harm; one that can lead to thoughts of suicide. Indeed, in many of these conversations, texters were experiencing thoughts of suicide and feelings of hopelessness and worthlessness. However, these texters did not want to end their lives and identified self-harm as a means to protect themselves from suicide. Many of these texters were seeking a healthier alternative to self-harm and a more effective way to cope.
Why do people self-harm?
In general, self-harm is often used as a coping mechanism to deal with severe emotional distress and managing unwanted, overwhelming thoughts and feelings. These can include issues such as present or past trauma (e.g. physical or sexual abuse, bullying, grief after bereavement or loss), pressures at work or school, relationship problems, financial difficulties, or mental or physical ill health.
In this context, it is thought that self-harm can represent an attempt to manage or gain control over extreme emotions or that it may elicit feelings of physical pain that distract from emotional pain; it may be also used as a form of punishment for feelings or behaviours that the individual deems as blameworthy.
Alongside what we see in our own data, research shows that self-harm is a strong risk factor for suicide, particularly amongst young people. It’s always important to bear in mind that someone who is self-harming can also feel suicidal and it must always be taken seriously.
“I was feeling very low - I was seriously thinking about ending my life but you helped me see things differently. I might be back in that really scary place again but I think I can stay that bit stronger until I talk to my Dr.” - Shout texter feedback
Although people often self-harm to feel better, the relief is often tempered by feelings of shame which has also been shown to correlate with suicidal ideation. Moreover, people who self-harm may contemplate suicide when self-harming ceases to offset the thoughts and feelings caused by their distress and no longer becomes an effective coping mechanism.
What can be done to support people who are self-harming?
Self-harming behaviour is often concealed, but there are some behavioural changes and signs to look out for:
- You may notice someone increasingly isolating themselves and withdrawing from social situations
- A person may have unexplained cuts, scratches, burns, bruises and wounds
- They may be covering up with long sleeves or trousers even in very hot weather or avoiding social situations where the skin is exposed, such as swimming
Someone may also directly tell you that they are self-harming.
It can feel difficult to discuss self-harm and know how best to help, but whether someone tells you directly or you suspect they may be self-harming, there are important ways you can help.
Let them know you are there to listen to them without judgement. Remember that there is more to them than their self-harm, and show compassion for what they are going through. Remind them of their past successes and things they do well. Offer to help them find support, but let them be in control of their decisions. Lastly, make sure that you check in with yourself too and reach out for support should you need it.