Understanding Self-Harm: A Guide for Young Adults and Those Who Care About Them

Why This Topic Matters

Self-harm is significantly more common among young adults than most people realise. Research from multiple countries suggests that around one in five young people have self-harmed at some point, with rates highest in the 16 to 24 age group. Despite its prevalence, self-harm remains heavily stigmatised, widely misunderstood, and rarely discussed openly. This combination of prevalence and stigma means that many young people who self-harm do so in isolation, without telling anyone, and without accessing the support that could help them find alternative ways of coping.

This guide aims to provide honest, non-judgmental information about self-harm: what it is, why people do it, how to seek help, and how to support a friend or flatmate. The aim is not to sensationalise or to alarm but to reduce the stigma and information gap that prevents people from getting support.

What Self-Harm Is and What It Is Not

Self-harm refers to intentionally hurting yourself as a way of coping with difficult emotions, overwhelming thoughts, or distressing situations. It most commonly takes the form of cutting, but can also include burning, hitting, scratching, or other ways of inflicting physical pain or injury on yourself. It is important to understand what self-harm typically is and is not.

Self-harm is usually a coping mechanism rather than a suicide attempt. Many people who self-harm are not trying to end their lives. They are using physical pain as a way of managing emotional pain that feels overwhelming or unmanageable. This does not mean it is safe or helpful in the long term, and it does not mean it can be dismissed. But understanding it as a coping strategy rather than a suicide attempt changes the appropriate response.

Self-harm is not the same as attention-seeking in the dismissive sense that term is often used. People who self-harm typically hide it carefully and go to significant lengths to avoid anyone finding out. When self-harm does become visible, it is often because the person is in considerable distress and may need more support than they have been able to access alone.

Why People Self-Harm

The reasons people self-harm are varied, but some themes are consistent. Self-harm can be a way of expressing emotional pain that feels impossible to put into words. It can provide a sense of control in situations where everything else feels out of control. It can be a way of feeling something real when emotional numbness has set in. It can be a way of punishing oneself that reflects deep feelings of shame or self-blame. And it can provide brief relief from overwhelming anxiety, depression, or other intense negative emotion, not because it is a healthy response but because it works in the short term as a release mechanism.

Understanding this context is important because it means that simply stopping self-harm without addressing the underlying distress it is managing is unlikely to work. The goal of recovery is not just to stop the behaviour but to develop other ways of managing the feelings that the self-harm is currently addressing.

Getting Help for Self-Harm

If you are self-harming, you deserve support, and the support available is genuinely helpful. You do not need to be in crisis to seek help, and you do not need to have stopped self-harming before speaking to someone. Reaching out while you are still struggling is entirely appropriate.

Your GP or family doctor is a good starting point. They can assess your overall mental health and refer you to appropriate support, which may include talking therapy, medication for underlying depression or anxiety, or specialist mental health services. University counselling services are specifically oriented toward supporting students with mental health difficulties including self-harm. Crisis lines provide confidential support at any time of day and are staffed by people trained to respond to self-harm without judgment.

When speaking to a healthcare or counselling professional about self-harm, you can be honest about what is happening. They are not there to judge you or to get you in trouble. Providing accurate information about the frequency, severity, and context of self-harm helps them provide the most appropriate support. If your injuries ever require medical treatment, seek it without shame. Medical professionals treat self-inflicted injuries regularly and their job is to care for your physical health.

Supporting a Friend Who Is Self-Harming

If you discover or suspect that a friend is self-harming, your initial response matters. The most helpful responses are calm, non-judgmental, and focused on the person rather than the behaviour. Expressing panic, disgust, anger, or extreme upset puts your emotional needs at the centre of the conversation and makes it less likely the person will feel able to speak honestly. Saying something like I care about you and I want you to be okay, and I am here to listen if you want to talk, opens a door without pressure.

Do not make promises you cannot keep, such as promising to keep it secret if telling someone might be necessary for the person's safety. You can say that you are not sure whether you will be able to keep this between you if it seems like they are in significant danger, and that your priority is their safety.

Encourage the person to speak to a professional and offer to help them find support or accompany them to an appointment. Following up after the initial conversation, checking in regularly, and maintaining the friendship without making every interaction about the self-harm shows that you care about the person rather than just managing a problem.

If you are worried that someone is in immediate danger of a serious injury or a suicide attempt, contacting emergency services or telling a trusted adult is appropriate. This will probably feel like a betrayal of trust in the moment, and the person may be very upset. But their safety is the priority, and most people eventually understand that a friend who kept them safe was acting from care.

Moving Toward Recovery

Recovery from self-harm is possible and is achieved by many people. It typically involves developing a broader repertoire of coping strategies, addressing the underlying mental health difficulties that drove the behaviour, and building a more secure sense of self-worth that does not require punishment. This work takes time and usually involves professional support. Progress is rarely linear, and setbacks are a normal part of recovery rather than signs that recovery is impossible.

The most important thing to know, whether you are self-harming or supporting someone who is, is that the situation is not hopeless and that effective support is available. Reaching out, despite the fear of judgement, is the first step toward something better.