How to help someone self harming: a compassionate guide

When you discover someone is self-harming, it’s natural to feel a rush of different emotions. But the most important thing you can offer them is empathy and support, not judgement. It’s absolutely crucial to understand that self-harm is a coping mechanism for intense emotional pain, not a bid for attention or a suicide attempt. The focus should always be on their feelings. Listen without interrupting and gently, kindly, encourage them to think about seeking professional help.

Understanding Why People Self Harm and How to Spot the Signs

Before you can offer any real help, you need to get your head around what’s driving this behaviour. Self-harm is almost always a physical outlet for deep emotional distress. It’s a way for someone to deal with overwhelming feelings like sadness, anger, numbness, or shame when they just don’t have healthier ways to cope.

For them, the act itself might bring a fleeting sense of release, or even a feeling of control in a life that feels completely chaotic. Think of it as a symptom of an underlying struggle, not the problem itself. This is a vital distinction—your focus should always be on the pain behind the action, not just the action.

Important Disclaimer: Please remember, I am not a mental health professional. The information in this guide is intended to offer support and guidance. If you are worried about someone's immediate safety or mental health, it is essential to seek help from a qualified professional, such as a GP or a registered therapist.

The Growing Pressures on Young People

The state of mental health among children and young people is a massive concern right now. Here in the UK, it's estimated that a staggering one in five children aged 8 to 16 have a probable mental health problem. These struggles don’t just appear out of nowhere; they’re often fuelled by the unique pressures of modern life.

Social media, for instance, can create a relentless cycle of comparison and inadequacy. The curated, perfect lives we see online can make young people feel like their own lives, bodies, and experiences are somehow falling short. This constant pressure can feed into anxiety and depression, which are common issues simmering beneath the surface of self-harm. Knowing these external factors exist helps you approach the conversation with far more empathy. You can learn more about identifying the signs of anxiety and depression in teens and children to better equip yourself.

Recognising the Warning Signs

People who self-harm often go to great lengths to hide it, which can make it incredibly difficult to spot. The signs aren't always obvious or physical. The real key is paying close attention to changes in their behaviour and appearance.

Physical Clues to Look For:

• Unexplained injuries: You might notice frequent cuts, scratches, bruises, or burns, often on their arms, legs, or torso.
• Wearing long sleeves or trousers: Covering up all the time, even when it's hot, can be a way to hide injuries from view.
• Keeping sharp objects: Finding things like razors, knives, or other sharp items in their room or bag without a clear reason.

Behavioural and Emotional Signs:

• Social withdrawal: They might suddenly pull away from friends, family, and hobbies they used to love.
• Mood swings: You might see signs of depression, anxiety, or irritability, or they might seem emotionally unstable and unpredictable.
• Low self-esteem: They may make frequent self-critical comments or talk about feeling worthless and hopeless.
• Difficulties at school or work: A sudden drop in their performance or attendance can be a major red flag.

Spotting these signs is the first, crucial step. It helps you shift your own mindset from confusion or fear to one of genuine concern and compassion. It’s what prepares you to offer the support they so desperately need.

Starting a Conversation That Actually Helps

Knowing what to say when you suspect a loved one is self-harming can feel paralysing. The fear of getting it wrong is huge, but staying silent is almost never the right answer. The goal here isn’t to solve everything in one go, but to open a gentle, supportive conversation that starts building trust.

First, you need to prepare yourself emotionally. It’s completely natural to feel scared, upset, or even angry when you discover this. But approaching the conversation in a state of panic will almost certainly make them shut down. Take a moment to process your own feelings so you can speak from a place of calm compassion. This isn't about hiding your concern; it's about making sure it lands as support, not pressure.

Setting the Stage for an Open Dialogue

Where and when you choose to talk matters more than you might think. You need a time and place where you won’t be interrupted, somewhere the person feels safe and comfortable. Confronting them in a public place or when either of you is stressed, tired, or rushing is a recipe for disaster.

Think about a moment when you’re both relaxed. Maybe during a quiet walk or while sharing a cup of tea at home. The setting itself should signal that this is a private, safe space where they have your full, undivided attention. Turn your phone off. Get rid of other distractions. Show them you are completely present.

These conversations are more critical than ever, especially here in the UK. We’re facing a significant youth mental health crisis, and the statistics are stark. Rates of self-harm are alarmingly high, particularly among young women. A staggering 25.7% of women aged 16–24 report having self-harmed in their lifetime—a figure that has tripled since 1993. This distress is widespread; referrals to emergency mental healthcare shot up by 10% last year, leaving countless young people stuck on long NHS waiting lists. These numbers, detailed in UK mental health statistics from the Priory Group, show just how urgent it is for friends and family to offer compassionate, early support.

Choosing Your Words with Care

The words you use can either build a bridge or put up a wall. The trick is to lead with "I" statements that express your feelings and what you’ve noticed, rather than "you" statements that can easily sound accusatory. This simple shift helps lower their defences and makes it easier for them to be honest.

So, instead of asking something like, "Why are you doing that to yourself?", which is loaded with judgement, try a much gentler opener. For example, you could say, "I've noticed you've seemed a bit distant recently, and I’m worried because I care about you. Is everything okay?" This approach immediately shifts the focus from the behaviour itself to their underlying emotional pain.

Your main job is to listen and validate their feelings, not to fix them. Simple phrases like, "That sounds incredibly difficult," or "I'm so sorry you're going through this," show that you hear them without passing judgement.

Learning how to communicate supportively is a real skill. If you'd like more practical tips on phrasing and active listening, our article on how to talk about mental health is a great place to start.

Helpful vs Harmful Phrases When Discussing Self Harm

When someone shares something so deeply personal, our gut reactions aren't always the most helpful. It’s a good idea to think ahead about what to avoid saying and what to aim for instead. This quick guide can help steer your conversation in a more constructive direction.

Avoid Saying This (Harmful)	Try Saying This Instead (Helpful)
"You're just doing this for attention."	"I can see you're in a lot of pain. I'm here to listen."
"Just stop it. You're hurting me too."	"I'm worried about you. How can I support you right now?"
"Why would you do that to yourself?"	"Can you tell me a bit about what's been going on for you?"
"You have nothing to be upset about."	"Your feelings are valid. Let's talk about them."

Remember, this first conversation is about creating a safe space where they feel they can be vulnerable. You don't need to have all the answers. The most powerful thing you can offer is your calm, non-judgemental presence, letting them know they aren’t alone. This one step can be the catalyst that encourages them to seek the professional help they need.

Providing Practical and Ongoing Support

That first conversation is a massive step, but the real support starts now. Words are crucial for building trust, but it's the practical, ongoing actions that truly show someone you're in their corner. Recovery isn't a straight line – it's full of ups and downs, and your steady, gentle presence can make all the difference.

It's so important to remember that you're a supporter, not a therapist. Your role is to help them find their own strength and connect with professional help, not to carry the weight of their recovery on your own. Looking after your own mental wellbeing isn't selfish; it's essential if you want to keep offering support in a healthy, sustainable way.

Collaborating on a Safety Plan

One of the most concrete things you can do is help them put together a safety plan. This has to be a team effort—you’re doing it with them, not for them. The aim is to create a simple, easy-to-follow guide they can grab when the urge to self-harm feels overwhelming.

A good safety plan usually covers a few key areas:

• Identifying Triggers: Gently talk through what situations, feelings, or thoughts tend to lead to the urge to self-harm. For instance, is it after a stressful exam, an argument, or when they feel lonely at night?
• Exploring Healthier Coping Strategies: Brainstorm a list of alternative things they could do instead. These need to be things they actually find calming or distracting, like going for a run or listening to a specific podcast.
• Discussing Means: If they’re comfortable with it, you can talk about removing things they might use to self-harm from their immediate environment. This has to be their choice, framed as a way of creating a safer space while they learn new skills.

Just going through this process can feel incredibly empowering. It helps shift the focus from feeling powerless to taking proactive steps, giving them a real tool to use in a crisis.

Finding Alternatives and Distractions

When someone is in the grip of intense emotion, having a pre-planned list of distractions and grounding techniques is a game-changer. These are simple actions designed to break the cycle of overwhelming feelings and pull them back into the present moment.

Here are a few practical ideas you could suggest:

• Breathing Exercises: Suggest a simple box breathing technique: breathe in for four seconds, hold for four, breathe out for four, and hold for four. Repeating this can calm the nervous system.
• Intense Sensations: Things like holding an ice cube, having a very cold shower, or snapping a rubber band on their wrist can create a sharp, physical jolt without causing lasting harm.
• Creative Outlets: Encourage them to get their feelings out by writing in a journal, tearing up paper, scribbling furiously on a page with a red pen, or even just blasting some loud music.

The goal is to find something that provides a release without causing injury. It’s all about creating a bit of space between the urge and the action.

This flowchart is a great little guide for getting yourself ready for these conversations, from preparing your own mindset to being an active listener.

As the visual shows, thoughtful preparation is the bedrock of a supportive and helpful chat.

Connecting Them with Professional Help

Your support is invaluable, but it can't take the place of professional expertise. Helping them access that help is one of the most important things you can do. The thought of finding a therapist, making that first call, and explaining everything can feel like climbing a mountain, so your practical help can be a real lifeline.

You could offer to:

• Help them research local GPs or mental health services online.
• Sit with them while they make the phone call to book an appointment.
• Go with them to the appointment and just sit in the waiting room.

The link between self-harm and seeking professional help is tragically stark. A landmark UK study of young people aged 10-19 who died by suicide between 2014-2016 found that 49% had a history of self-harm. Crucially, 88% of these young people had reached out to a GP or mental health service before their death. This shows just how vital these interactions are as chances to intervene. You can read the full research about these findings to really grasp the importance of proper assessments.

Remember, the goal is to empower them, not to take over. Your role is to remove barriers and offer encouragement, reinforcing the idea that seeking help is a sign of strength.

Being ready to support someone through these first steps can change everything. If you want to build your confidence and skills even further, looking into something like Youth Mental Health First Aid training can be incredibly helpful. Your consistent, non-judgemental support is a powerful anchor in a turbulent time.

Navigating the UK Mental Health System

Trying to find the right professional help can feel like you’re lost in a maze, especially when you’re already overloaded with stress and worry. The good news is that there are clear, established pathways for support here in the UK. Knowing what they are can give you the confidence to help guide your loved one towards the help they need.

For most people, the first and most important port of call is their General Practitioner (GP). A GP is essentially the gatekeeper to most NHS mental health services, and they are well-trained to handle these conversations with care and sensitivity.

When you or your loved one goes to the appointment, it really helps to be prepared. Encourage them to be as open as they can about what's been happening. The GP will likely ask about their feelings, the self-harm itself, and anything that might be triggering it. This first conversation is completely confidential and is the starting point for getting a referral to more specialised services.

Understanding NHS Services

Once the GP has a good understanding of the situation, they can refer the person to the right mental health team. Which service that is will depend on their age and just how serious their needs are.

For children and young people under 18, this usually means a referral to CAMHS (Child and Adolescent Mental Health Services). CAMHS teams are made up of specialists like therapists, psychologists, and psychiatrists who are experts in youth mental health.

For adults, the referral will be to the local Adult Mental Health Team (AMHT). These teams provide assessment, diagnosis, and treatment for a huge range of mental health conditions. It's worth knowing that waiting lists for these services can sometimes be long, which is why having other support in place while you wait is so important. To get a better feel for the range of professional help available, you can also explore available mental health services.

Please remember, I am not a mental health professional. This information is for guidance, but it is not a substitute for clinical advice. If you are worried about someone's immediate safety, you must contact a doctor, call 111, or go to A&E.

Essential Helplines and Charities

While you're navigating the NHS system, charities and helplines can be an immediate and vital lifeline. They offer a confidential listening ear, expert advice, and specialist support for both the person struggling and for you as a supporter.

Here’s a list of fantastic UK organisations you can turn to anytime:

• Samaritans: Available 24/7 for anyone who is finding it hard to cope and just needs someone to listen without judgement. You can call them for free on 116 123.
• Mind: A leading mental health charity that provides brilliant advice and support. Their Infoline (0300 123 3393) offers information on mental health problems, where to find help, and your legal rights.
• YoungMinds: This charity is specifically focused on supporting the mental health of children and young people. They run a Parents Helpline (0808 802 5544) which offers detailed advice and support for any concerned adult.
• The Mix: An essential free, confidential support service for young people under 25. They offer help over the phone, via email, and through webchat on everything from mental health to money worries.

These services can bridge the gap while waiting for an NHS appointment and provide amazing ongoing support throughout the recovery journey. Knowing they exist means you are never truly alone in this. I'd recommend saving these numbers in your phone—it can bring huge peace of mind knowing that help is just a call away whenever you or your loved one needs it.

Finding Positive Outlets for Healing

Real recovery isn't just about getting through a crisis. It's about slowly, gently building a life where healthier coping skills start to feel more natural than harmful ones. Once the immediate storm has passed, the focus can shift towards exploring positive, long-term tools for healing.

These outlets aren't meant to replace professional therapy. Think of them as powerful companions on the journey, helping someone rebuild their sense of self beyond their struggle. It’s about helping them find light and colour in a world that might have felt grey for a very long time.

Important Reminder: I am not a mental health professional. The suggestions in this section are intended as supportive ideas, not clinical advice. If you are worried about someone, please encourage them to speak with a GP or a registered therapist who can provide expert care.

The Power of Words and Stories

One of the gentlest yet most effective tools out there is bibliotherapy – a simple term for using mental health books to support mental health. Reading stories or practical guides can make someone feel less alone, offer a fresh perspective, and provide real strategies for coping.

The right book can feel like a quiet, understanding friend.

Here are a few types of books that can be particularly helpful:

• Books on Emotional Regulation: These are brilliant for learning practical techniques to understand and manage intense feelings. The Dialectical Behavior Therapy Skills Workbook is a classic for a reason, filled with useful exercises.
• Memoirs and Personal Stories: There’s incredible validation in reading about someone else’s journey through similar struggles. Matt Haig’s Reasons to Stay Alive is a hugely popular choice that offers real comfort and hope.
• Mindfulness and Self-Compassion Guides: Books like Self-Compassion: The Proven Power of Being Kind to Yourself by Dr Kristin Neff can be transformative. They teach the importance of treating yourself with kindness, a piece of the puzzle that's often missing for those who self-harm.

For many, discovering things like bedtime stories for adults with anxiety and stress can also be a game-changer, offering a soft place for a racing mind to land at the end of the day.

Creative and Physical Relaxation

Beyond reading, finding other ways to express and relax is key. The goal is to channel difficult energy into something creative, calming, or physical. These activities help quieten the mind and offer a healthy distraction when urges feel overwhelming.

A few simple ideas to try:

• Mindful Colouring: There's a reason adult colouring books are so popular. Focusing on intricate patterns like mandalas can be incredibly soothing.
• Journaling: Simply writing down feelings without any judgement can provide an enormous sense of release. It doesn’t have to be perfect; it just has to be honest.
• Gentle Movement: Activities like yoga, a quiet walk in nature, or even just stretching can help release physical tension and give your mood a much-needed lift.

The wider impact of this is huge. Untreated mental health issues cost UK businesses an estimated £56 billion a year in lost productivity and absenteeism. It just goes to show how vital it is to build these skills from a young age.

Small Acts of Self-Empowerment

Sometimes, healing is found in small, tangible symbols of progress. This is where something as simple as mental health apparel can play a part. A t-shirt or a hoodie with a positive message isn't a cure, of course, but it can be a powerful daily reminder of their own strength and commitment to recovery.

It’s a small but visible way for someone to start reclaiming their identity and wrapping themselves in a message of hope.

These positive outlets are crucial for everyone, but especially for young people in difficult situations. Self-harm within the UK’s youth secure estate remains a serious concern, with a rate of 188 incidents per 100 young people in early 2025. These figures highlight the desperate need for more trauma-informed care and positive coping mechanisms in high-risk environments. By encouraging these small, positive steps, we help build resilience for the long haul.

Common Questions About Supporting Someone

Navigating this journey with someone you care about is bound to bring up some urgent and sensitive questions. It's completely normal to feel unsure, but having clear, direct answers can help you act with confidence and compassion right when it matters most. This section is here to offer that reassurance and give you practical steps for those really difficult moments.

Remember, the goal is always to keep them safe and show your unwavering support.

What Should I Do If I Find Out Someone Is Actively Harming Themselves Right Now?

If you believe they are in immediate danger of serious harm, their physical safety is the absolute priority. Call 999 for an ambulance immediately. Your presence can be a grounding force in a moment of intense crisis, so stay with them if you can, offering calm reassurance while you wait for professional help to arrive.

If the danger isn't life-threatening but you are still very worried, you can call NHS 111 for urgent advice. If it's possible, taking them to the nearest A&E department is another crucial step.

In these critical moments, your only job is to get them to safety. Professional medical help isn't just important; it's essential. Please don't try to manage a medical emergency on your own.

Should I Tell Their Parents or Another Adult?

This is one of the toughest dilemmas you might face, and the answer really depends on the person's age and how serious the risk is.

If the person struggling is under 18, their safety has to come first. The ideal scenario is to gently encourage them to talk to a parent or another trusted adult themselves. You could offer to be there with them, saying something like, "I think it's really important your parents know so they can help. I can sit with you while you tell them if that makes it easier."

However, if they are at significant risk and refuse to tell anyone, you may have to break their confidence. I know how hard that sounds, but this isn't a betrayal; it's an act of care. Explain to them calmly why you need to inform a responsible adult—like a parent, teacher, or school counsellor—to make sure they get the help they need to stay safe.

What If They Relapse After a Period of Doing Well?

It’s so important to understand that relapses can be a normal, albeit disheartening, part of the recovery process. Your reaction at this moment is incredibly important. Try to avoid showing disappointment or anger, as this can easily trigger feelings of shame and failure for them.

Instead, approach them with the same compassion and support you showed from the very beginning.

• Validate their feelings: Acknowledge that this is a difficult setback, without any judgement.
• Reinforce their progress: A slip-up doesn't erase all the hard work they've already put in. You could say, "This is a tough moment, but it doesn't change how far you've come. I'm still right here with you."
• Encourage professional reconnection: Gently suggest they get back in touch with their therapist, GP, or another professional who has been supporting them.

Your consistent, non-judgemental presence is the anchor they need to get back on track. A calm reaction reinforces that they are not a failure and that recovery is still possible.

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