Worried about a friend or loved one? We share 10 ways you can help and support someone who self-harms

Self-harm can affect individuals at any age. No matter what their situation, both those with and without other mental health concerns may turn to self-harm as a way to cope with how they are feeling. While it is more common in young people (recent statistics have suggested nearly one in four girls have self-harmed by the age of 14), self-harm can encompass a wider range of activities and behaviours than we may realise.

Experts say around 50% of those who self-harm do not receive the help and support needed. Once someone is in a cycle of self-harming, stopping can be tough. Many find a combination of self-help techniques and professional support can have a significant impact.

How can I help someone who self-harms?

If you are worried about a friend or loved one, there are plenty of things you can do to offer help and support.

1. Listen to them

The reasons why people self-harm can be varied and complex. For some, it is a way to gain control when they are feeling otherwise overwhelmed; for others, they may not even know why they have developed the habits that they have with physical or cyber self-harm. While some people may dismiss self-harming behaviours as attention-seeking, others may worry that all forms of self-harm are linked to suicidal thoughts. Try not to jump to conclusions.

Three friends talk together

Counsellor Graeme Orr MBACP (Accred) explains, “Self-harm is rarely an attempt at suicide and while risky behaviour can always go wrong, it is a coping mechanism, perhaps to let emotions out or to punish themselves.

“So, how can you help? Recognise that you may need support to help deal with your feelings. Really take time to listen to how they feel. Ask how they are, and don’t try to make them feel guilty about the effect on others or try to judge their behaviour.

“Make sure that they know you are ready and willing to talk to them. Do not set limits or make threats. Understand that [recovery] is a long process.”

2. Be available (without being overwhelming)

When someone we care about is struggling, our first instinct is often to offer our help and support. However, there can be a clear difference between making sure that a loved one knows we are there for them, and being too suffocating or pushy.

Once you have let them know that you are there if they need someone to listen or want to talk, try to take a step back and give them the space to open up in their own time. Don’t take it personally if they aren’t ready to speak; they may not yet feel ready to talk to anyone. Some people may feel ashamed or guilty about how they are feeling, or could be worrying that they may be pushing their problems onto those they love. By making sure that they know you are there when they are ready to talk, it can help to open the lines of communication without adding too much pressure in the moment.

3. Be mindful of when (and how) you start the conversation

No-one wants to feel like they are being ambushed or pressured into a conversation they aren’t ready for. If a friend has recently opened up to you to share what is going on, or if you suspect they may be self-harming but are not certain, try to be mindful of how you raise the topic.

It’s important to do your best to remain non-judgemental throughout the conversation if you can. If you’re unsure of how to start the conversation, here are some great suggestions on how you can talk about self-harm sensitively.

Two friends sit together outside talking

4. Support them in seeking professional help

No matter how much we want to help, support from friends and family can only go so far. You may have the best of intentions, but the likelihood is that you can’t (and shouldn’t try to) replace professional healthcare support and treatment.

By speaking with a professional, trained counsellor or therapist, your loved one may be able to discuss distressing thoughts and feelings that they may otherwise be too nervous or hesitent to raise with someone closer to them. A professional will be able to help them work through how they are feeling, and start to recognise how these feelings are affecting their overall wellbeing as well as specific behaviours.

Mental health professionals can help to teach new coping strategies that can help them to deal with self-harming thoughts or behaviours. It can be tricky to take the first step towards admitting that they may need help. If they seem hesitant, you could suggest they reach out to a support line such as the Samaritans, who are available to listen 24/7, 365 days a year. The Samaritans are also available to talk via email, post, or in branch. Find out more about how you can help support someone who you are worried about with the help of the Samaritans.

5. Offer alternative ways to ‘talk’

If they are struggling to talk about how they are feeling, or have trouble verbalising their thoughts, it could be worth suggesting other ways they can express themselves. Writing things down or practising journaling can be therapeutic and may help if they aren’t yet ready to open up with someone else.

Starting a conversation via messaging app, by email or text can also make it easier for some people to open up. Having the extra distance provided by the screen can help some people feel more comfortable or confident in articulating what they are feeling. This can also help them to reach out when they are ready, rather than waiting or feeling pressured to do so in person.

6. Avoid making self-harm the only topic

Making sure you are there for them is great, but you know what is just as important? Ensuring that they feel like they can talk to and connect with you beyond their ill mental health. Finding a balance can be tricky, and you may feel awkward at first, but in the long run you will both appreciate it. No-one wants to be reduced to their label. Make sure you avoid falling into the trap of seeing your loved one as just a diagnosis.

Two friends chat over tea

7. Look after your own mental health

If you’re worried about a teen or relation, it can be tempting to let your thoughts turn inwards. Where did I go wrong? What did I do? How did I miss the signs? Did I drive them to this? Feeling this way can be a normal part of the process of dealing with big changes and challenges, but it’s important to remember that people self-harm for a wide variety of reasons. You can’t blame yourself.

Try to be honest with yourself about how their self-harming makes you feel. It’s ok to feel uncomfortable, upset, or even frightened. But try not to react with anger or look for someone to blame. You can still support your loved ones without sacrificing your own mental health.

8. Practice empathy and understanding

Leave your judgement at the door. How you react and relate to your loved one is a key part of helping them feel supported. You can do this by trying not to judge or speculate as to why they have self-harmed. Ensuring you are doing your best to relate to them as a whole person, rather than focusing on their self-harming behaviours can also help.

If in doubt, try to focus on having open, honest communication. Remind them of their positive qualities, and all the things that they do well. This can help them to feel supported and can help break the cycle of negative thinking in the moment. Where possible, avoid trying to force change, take charge or remove their options. These can all risk alienating them, which could make them less likely to open up.

9. Keep in mind: recovery and relapse are both possibilities

Recovery isn’t always a linear process. With the right support, recovery is completely possible – however, relapses are still possible, too. Old or bad habits can be easy to fall back on in times of change, high emotion, or stress.

If you are worried that a friend may be relapsing, try not to be discouraged. Remind them of their progress and strength. Remind them that they aren’t alone, and they deserve happiness. It’s never too late to reach out and seek support - no matter how dark things may seem.

A framed motivational sign, saying 'You got this'.

10. Remain positive

Avoiding disaster thinking can be tough, but it’s important to remember: self-harm and suicidal thoughts aren’t always linked. People may self-harm to deal with strong feelings of anger or sadness, as a form of self-punishment or distraction. Some people do it to try and communicate with others, or to gain a sense of self-control. As Rethink Mental Illness explains,

“People who self-harm don’t usually want to die. [They] may self-harm to deal with life, rather than [as] a way of trying to end it. But self-harm can increase your risk of suicide. People who self-harm should be taken seriously and offered help.”

Finding help and support

If you are worried about a friend or a loved one, encourage them to speak with their GP to find out what support is available in their local area. If you are worried they may be in immediate danger, call 111, 999, or visit your local A&E department.

You can find out more about self-harm and the treatment available through Rethink Mental Illness, the NHS Health A to Z, or through Counselling Directory.

If you are a parent worried about a child or teen who is self-harming, YoungMinds have some great resources and advice.

If you are looking for detailed advice on what to expect at every stage of the journey to finding help and support for self-harm, Rethink.org cover everything from treatment to advice for carers and friends.