Self harm in children

Behavior & Development • Jan 31, 2023

What to Know About the Increase in Self-Harm in Children

Over the past few years, St. Louis Children’s Hospital and other children’s hospitals around the country are seeing an increase in adolescents and even younger children with suicidal behaviors. We are also seeing an increase in children who engage in self-harm. You may be wondering, what is self-harm in children and adolescents, and is it related to an increase in suicide attempts?

What is self-harm?

Self-harm in children, also called non-suicidal self-injury (NSSI), is when children hurt themselves on purpose without intending to kill themselves. While engaging in self-harm may not mean that your child is having thoughts of suicide or wanting to die, studies suggest that children with NSSI do face higher risks for suicidal ideas and actions. Therefore, if you notice self-harming in your child, you should address this with your pediatrician.

What are self-harming behaviors?

Self-harming behaviors include skin cutting (the most common form), head-banging, burns, hair-pulling, excessive scratching of the skin, punching, inserting objects into body openings, and drinking harmful substances. Studies suggest that female children are likelier to self-harm by cutting, while male children are likelier to hit themselves. Self-harming behaviors are most common among teenagers, however, younger children may also self-harm. In addition, children who experience other mental health problems, such as anxiety, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), eating disorders, or personality disorders, are at higher risk of engaging in self-harm.

Why does self-harm happen?

There is not one single cause. Children who self-harm often feel overwhelming emotions, such as feeling lonely, worthless, or empty, and state that self-harming allows them to feel better for just a moment. Other children may self-harm because they feel they have done something bad, and want to punish themselves. Other children may feel that they have no control over any other aspects of their lives, and self-harming allows them to feel control over their bodies. It is also possible that self-harming may lead to a burst of endorphins or other natural painkillers that may cause the child to feel better at that time.

What are some signs of self-harm to look out for?

You may notice cuts or scars on your child’s hands, wrists, stomach, legs, or other parts of the body. Your child may also try to cover those areas by wearing long sleeves or long pants, even in hot weather. You may also notice symptoms of depression, such as low energy levels or trouble sleeping.

How can I help my child if they are showing signs of self-harm?

It can be difficult to distinguish if your child is engaging in NSSI or if they are truly suicidal. If you do notice your child engaging in self-harming behaviors or notice any signs of self-harm, such as cuts or scars, you should reach out to your child’s pediatrician, therapist, or the nearest emergency room. If you are concerned about self-harm, you can also discuss your concerns with your child, taking a non-judgmental position and listening to your child’s reasons for self-harming. However, it is also common for your child to deny they are self-harming or become defensive. If you are concerned about self-harming behaviors, you can also help by removing hazards in your home, such as sharp knives, razors, poisons, or weapons, or making them inaccessible to your child.

The good news is that with treatment, most children can recover and stop their self-harming behaviors. If you are concerned that your child might be exhibiting any of these behaviors, reach out to your pediatrician or call our Parent Helpline at 314-454-8336.