Teen mental health and self-harm: How to help

Over the past few weeks we’ve been looking at self-harm. Self-harm is a behaviour associated with mental health that is rarely talked about, but is actually quite common. Rates of self-harm in teenagers range from 14-39%. There are a lot of misconceptions and mystery around this behaviour. In my first post we looked at why teens self-harm. The second post was about understanding how it feels to be someone who self-harms. In this post, the final part of the series, we will look at how to support teens who self-harm.

If you’ve read the first two posts you will know that I suggest professional help is a must for supporting someone with self-harm. This is not a plug for my services – I don’t mind where you get help! But seeking help is really important. So whilst the ideas in this post can be hugely supportive, they are not suggested to a replace professional help, but to compliment it. Professionals will take a different role to parents, wider family or friends and all can become part of a support network. Here are some ideas for you if you are wanting to support a teen right now. And if you are a teen that’s struggling, read this and think about what you need from others. If you get some ideas, then communicate this to these who are supporting you.

Reaction

Confiding in someone when you have self-harmed, or having someone else find out about your self-harming behaviour can be very scary. Your child or friend may have spent a lot time working up the courage to admit that they need help. Or they may have put a lot of effort into hiding this behaviour. Remember all these feelings of shame and guilt? When we admit to something that we feel ashamed about, we will usually be pretty worried about how the person will react. Of course as a parent especially, it can feel shocking to find out your beautiful child is struggling with self-harm. But the best way to help at this very early stage is to react calmly. Think about containing the many and intense emotions they are likely to be feeling, rather than adding to them. By reacting calmly and with empathy, you are communicating that this is something that is safe for them to share, and that you are here to support them.

Don’t go it alone

Remember, a support network is not made up of one person. Whilst self-harm is something we don’t talk about much openly, it doesn’t mean keeping it secret is always wise. Supporting someone, be it a friend or child can be hard. So yes respect their confidentiality but make sure that you yourself have support too. This might be through others that support them, or it might be someone close to you that you can confide in. If you are a teen reading this, supporting another teen, this is massively important. Friendships can be close-knit and that can make situations like this difficult. If you feel stuck, speak to someone anonymously to try to find a solution. For Canadian teens and young adults Kids Help Phone will give you immediate access to a qualified counsellor.

Make a plan

This might be the first time you have heard that your teen or friend is self-harming, or it might be a regular occurrence. There might already be a plan in place, especially if a professional is involved. Or you might not know where to start. Either way, plan the next steps together.

If you have a plan in place, and your teen has self-harmed, get the plan out. Make it part of the routine as this will help with following it. Use the plan to work out your next steps. What are you going to do right now?

If you don’t have a plan, make one, right now, for the next few hours. First consider what is needed to make the situation safe. Do you need medical help? Does your child need practical care? Do they need comfort and to move into a different room? Can they be in a place where objects such as sharps are not accessible until you have sought professional help? Think about what they are going to do next? Choose an activity and follow though. Will they be alone or in company? Self-harm can be isolating and urges can be stronger when you are alone. So consider finding something to do together.

Finally, consider the plan for the future. Is your teen wanting support to stop self-harming? Make a plan for seeking professional help. Be curious about what else will help them at the moment. Ask what they need from you. Ask how you can help. If they are already on the road to stopping, but are struggling, think together about how your plan could be adapted. What would be helpful for next time? Be curious and pragmatic.

Communication

First, listen. Be the person that they can talk to. Because it might help for them to share how they’re feeling, and what has led them to this behaviour.

Secondly, don’t be surprised if they have nothing to say. Remember that self-harm can numb these big feelings. This can sometimes make it difficult to organise what you are feeling and why. Put simply, words might be too hard. Added to that, shame and guilt can get in the way of communication.

So be creative. Yes listen in person. But how about also telling your teen that they can text you at any time? How about starting a messenger conversation with them, when they are upstairs to see if they’re ok.

Sometimes communication can become a way to help with stopping self-harm. When urges to self-harm are hard to resist, if this can be communicated to you as a parent, then you can help them with this. You can work out a system for this together, if words are difficult. Sometimes a simple action such as giving you a red card can be a signal that they need help. The key is to talk, and find ways of communicating that work for you.

Distraction

One of the most effective ways to help someone who is trying to stop self-harming is distraction. Remember, these urges can be constant, and can get louder or quieter depending on the person’s mood and the situation. When the urges to self-harm are loud, it can be very difficult to resist. But urges will wane over time, and the peak will only last a number of minutes. So at these times, distraction is helpful.

No need to tiptoe

If mental health issues are not something you are used to, sometimes it can feel that you need to do a lot of things differently, change the routines around and to change your parenting style dramatically to be supportive. You might feel like you need to watch them 24/7 or that they shouldn’t be attending school or clubs. Now obviously there might be special circumstances where close supervision or a change in routine is needed. But if distraction is helpful, usually that means doing things is helpful. Generally, keeping things pretty normal is best. What is normal for you and your family, that is.

Be with, not against

As a parent of course you want your child to stop self-harming. It feels completely wrong. But forcing someone to stop never works, and going down this path can easily become less like support and more like a battle. Family dynamics can be challenging during the teen years, and especially if self-harm is an ongoing problem, it can feel frustrating. But it’s important to remember, self-harm is the behaviour showing your child is hurting. Stopping this behaviour might take some time, and some work. You are both together in this, and are on the same side. When big emotions are involved it’s easy for tension to mount and suddenly you’re arguing – togetherness is lost. So start again. Cool down. Go back to that curious empathic stance and come alongside your child. And if this feels too hard, use support. And start again.

I hope this short series on self-harm has been helpful. Yes it can feel complicated, but in essence, supporting someone who is struggling with this behaviour is about being there. If you are willing to face this with them together, then that in itself is a massive support. If you need further help with self-harm for you or your child and you live in Nova Scotia we can help at Imagine Therapy.

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