Megan Polanin, PhD, and Rebecca Cooper, National Center for Health Research
What is Self-Injury?
Self-injury is when a person harms their body on purpose. This article focuses on self-injury with no intention for suicide (Here is an article from our website focused on risk factors for youth suicide, and here is another about suicide prevention). Self-injury usually does not end in suicide, but the individuals performing these harmful behaviors are at higher risk for suicide if they do not get the help they need. Around 18% of adolescents self-injure per year, and more females tend to hurt themselves than males. Self-injury usually begins during the teenage years and declines with age. Some individuals might engage in this behavior several times and then stop, but others may have more trouble stopping.
In a recent study, researchers studied trends in emergency room admissions and discovered a surprising fact. Between 2001 and 2015, hospital staff reported over 40,000 admissions due to self-injury (poisoning, burning, cutting with a dull/sharp object). The number of these visits started to increase in 2009 and continued to rise until 2015. As a result, the annual rate of self-injuries (per 100,000 people) among females ages 10 to 24 nearly doubled from 2009 to 2015. The trend for male self-injuries did not increase at this same shocking rate. Researchers and other scientists are trying to find a reason for this sharp uptick, but it remains unclear.
Experts in the field debate whether these behaviors lead to suicidal thoughts. Regardless, it can be frightening if your child or someone you know displays these behaviors.
Why is this happening?
It is difficult to pinpoint one specific reason for this increased trend. Researchers looked at whether factors such as how much time teens spent on homework or how often they used social media were related to self-injury. Most agree that there is a link between time spent on social media and depression, which can lead to self-injury behaviors. A recent study suggests that adolescent girls are more likely than boys to belong to the LGBTQ community and have been sexually assaulted or bullied online.
Effect of Social Media
Teenagers have always experienced mental health problems due to a combination of their genes, family environments, and other factors like history of being victimized through bullying or trauma. Some researchers argue that too much screen time and limited face-to-face social interactions can make things worse for vulnerable teens.
One reason this behavior may be affecting adolescent females more than males is the differences in the way they interact with social media. For example, researchers from Johns Hopkins University discovered that females are “much more intensively engaged” than males with texting and social media applications on their phones. According to this study, this kind of excessive phone use among young people has been linked with depressed mood.
What Can Parents Do?
Because these self-injury behaviors are increasing among youth, parents who are concerned should take extra precaution. Below are some things you can do to help keep children/teenagers safe:
Notice signs. It can be easier to notice emotional changes in a child before seeing actual physical harm. If you identify major changes in your child’s relationships, communication or school performance, be on alert for possible signs of self-injury. Look out for small, parallel, linear cuts on a forearm, upper arm, or leg. Also, look out for unexplained cuts or scratches, especially if they appear regularly. These are usually attempted to be hidden by long-sleeve clothes, so also watch for a shift in wardrobe.
Talk with your child. It can be difficult to figure out where to begin if your child is displaying self-injury behaviors. If you are worried, it is best to be very careful when you begin this conversation. For example, when you bring the topic up, make sure to remain calm and focus on the fact that you love your child and are concerned about their cuts. Emphasize that you are trying to understand where your child is coming from and not judging their actions.
Connect with your child’s primary care provider or therapist. Talking with your child’s primary care provider may provide some comfort and help your family develop an action plan. A mental health professional can be a great support for your child to talk through what they are experiencing and develop healthy coping skills. A safe, nonjudgmental space can help your child express pain that underlies self-injury behavior.
To find a therapist, use SAMHSA’s (Substance Abuse and Mental Health Services Administration) Behavioral Health Treatment Services Locator, or call SAMHSA’s National Helpline (1-800-622-4357). Remember: If the situation is potentially life-threatening, call 911 or go to a hospital emergency room immediately.
Take household safety seriously. Parents should consider what types of medications are in the house and whether matches, knives, or other sharp objects, such as razor blades or scissors. Even if you think they are well hidden, they can potentially be dangerous. If you have concerns about your child’s behaviors, make sure these objects are in a safe, secure place.
Use available support and resources. There are many free education and support resources available. Below are some resources for you and your child to explore:
- Self-Directed Violence and Other Forms of Self-Injury (Centers for Disease Control and Prevention)
- Self-Harm Information (National Institutes of Health)
- Talk about Mental Health: For Parents and Caregivers (U.S. Department of Health and Human Services)
The good news is self-harm behaviors tend to resolve before teens reach adulthood without much intervention. However, this does not minimize potential risks during the teenage years. Teenagers who experience anxiety and depression are about six times more likely to self-harm than teenagers who do not experience anxiety and depression. If you are concerned your child might be engaging in self-injury behaviors, make sure to talk with a professional you trust to get your child the help they need.
- U.S National Library of Medicine, “Self-Harm”. 2/26/16. Referenced from <https://medlineplus.gov/selfharm.html>
- Mercado MC, Holland K, Leemis RW, Stone DM, Wang J. “Trends in Emergency Department Visits for Nonfatal Self-inflicted Injuries Among Youth Aged 10 to 24 Years in the United States, 2001-2015.” JAMA. 2017;318(19):1931–1933
- Scutti, Susan. Self Inflicted Injuries Surge Among Tween and Early Teen Girls. CNN.com. 11/21/2017. Referenced from <http://www.cnn.com/2017/11/21/health/self-inflicted-injury-cdc-study/index.html>
- Lenhart, A., Page, D., Teens, Social Media & Technology Overview 2015. The Pew Research Center. 4/9/2015. Referenced from <http://www.pewinternet.org/2015/04/09/teens-social-media-technology-2015/pi_2015-04-09_teensandtech_06/>
- Eltagouri, M. More Middle School Girls are Inflicting Self-Pain. Experts Say it Might Be Because of Smartphones. 11/21/2017. Referenced from <https://www.washingtonpost.com/news/to-your-health/wp/2017/11/21/more-middle-school-girls-are-inflicting-self-pain-experts-say-it-might-be-because-of-smartphones/>
- Healy, M. Self-Harm Rises Sharply Among Tween and Young Teen Girls, Study Shows. LA Times. 11/21/2017. Referenced From <http://beta.latimes.com/science/sciencenow/la-sci-sn-tween-girls-self-injury-20171121-story.html> Mental Health America, “Self-Harm”. Referenced from <http://www.mentalhealthamerica.net/self-injury>
- Baumgaertner, Emily. “How Many Teenage Girls Deliberately Harm Themselves? Nearly 1 in 4, Survey Finds.” The New York Times. 7/2/18. <https://www.nytimes.com/2018/07/02/health/self-harm-teenagers-cdc.html>