Self Harm

Self-harm is when a youth intentionally hurts themselves as a way to cope with stress or emotional pain, without intending to end their life. This resource is for parents and guardians to help understand self-harm, recognize signs, and support their youth both immediately and over time.

Self-harm refers to a coping response when a person intentionally hurts themselves as a way of coping with overwhelming distress or emotional pain.

Self-harm is a common concern among adolescents and young adults. Research suggests that about 1 in 5 young people may experience self-harm at some point during adolescence. Not all young people who engage in self-harm have a diagnosable psychiatric disorder. Self-harm most often begins during early adolescence, commonly between the ages of 12 and 14, although it can occur at any age.

Self-harm is often a sign that a young person is experiencing emotional distress and may be having difficulty finding effective ways to cope. With understanding, support, and appropriate treatment, young people can learn safer ways to manage difficult emotions and experiences.

As a parent or guardian, discovering self-injurious behaviour can be alarming, yet your response can help make a difference. This resource is for parents and guardians to help them understand self-harm, recognize signs, and support their young person both immediately and over time.

What you need to know

Self-harm is not the same as attempting suicide, but it can become ongoing if underlying stress is not addressed
Self-harm is most often a coping strategy for overwhelming emotions or stress
Youth who self-harm need understanding, support, and professional help over time
Self-harm can include a range of behaviours where a person intentionally hurts themselves. This may involve causing injuries to their body, using objects to harm themselves, or swallowing something that could cause harm.
Self-harm is different from a suicide attempt, although some young people who self-harm may also experience thoughts of suicide. Any self-harm should be taken seriously because it can increase the risk of future self-harm, suicide attempts, or accidental serious injury.
Youth who self-harm benefit from understanding, support, and assessment by a healthcare or mental health professional to determine what help is needed. Responding with care, curiosity, and without judgement can help you understand what is contributing to your young person's distress while supporting them in developing safer coping strategies and reducing access to items that could be used for self-harm.

Symptoms / Signs / Causes

Common signs of self-harm may include:

Cuts or scratches on the surface of the skin
Burn marks on the skin (for example, from cigarettes)
Taking too much medication, but not enough to be life‑threatening (“minor overdosing”)
Hitting their head, such as against a wall
- Intentionally hitting or banging their head or punching walls or other hard objects.
- New or unexplained physical marks such as cuts, scratches or burn marks on the skin.
- Hiding medication or taking more medication than prescribed.
- Frequent bandages or clothing worn to cover injuries, even in warm weather.
- Blood stains on clothing or bedding.

Why people self-harm

Many mental health professionals believe self-harm is used to cope with stress. Common reasons include:

To get relief from painful or distressing feelings
To cope with feeling emotionally numb
To communicate pain or distress to others when words are difficult

Although these needs are real and understandable, self-harm may only provide temporary relief, does not solve the underlying problem and can create additional difficulties over time.

Diagnosis / Assessment

Self-harm is identified through conversations with the youth, observation of behaviours or injuries, and mental health assessment by a healthcare provider or mental health professional.

When seeking professional support, a thorough assessment should include understanding a young person's safety, including any thoughts or plans of suicide, as well as exploring what self-harm is helping them cope with or communicate.

Some reasons may include:

Reducing intense emotional distress
Communicating emotional pain or a boundary
Regaining a sense of control
Interrupting numbness or feeling disconnected
Self-punishment or responding to shame

Treatment or Procedure

Self-harm is usually treated through talk therapy. Effective treatment helps youth:

Identify triggers that lead to self-harm
Improve problem-solving skills to manage stress better
Learn to regulate emotions and find healthier coping strategies
Change unhealthy thoughts into more positive ones
Build social and communication skills to resolve conflict and seek support

Although not every young person who self-harms will require ongoing therapy, professional support is strongly recommended when self-harm is repeated, increasing in frequency or severity, causing distress, or difficult to stop.

Family involvement is often an important part of treatment. Therapy can help youth and families:

Understand triggers and situations that contribute to self-harm
Develop problem-solving skills to manage stress and challenging situations
Learn emotion regulation skills and safer coping strategies
Identify and change unhelpful thinking patterns
Build communication skills to express needs, manage conflict, and help-seeking behaviours

Aftercare / What to do at home

How you can help right now

Show you care: Tell your youth you love them and are concerned
Acknowledge their feelings: Ask how you can help or support them
Learn basic first aid: Care for minor injuries; offer medical care if needed
Build trust: Avoid showing disgust or guilt; listen without anger
Encourage self‑soothing: Music, reading, exercise, or calming activities
Be patient: Treatment takes time; asking them to “just stop” is not helpful

Important: Removing self-harm without replacing it with healthy coping skills can increase risk.

Your response matters. It is normal to feel alarmed, scared, or unsure when you discover that your young person has self-harmed. Try to remind yourself that self-harm is often a sign that they are struggling and need support developing safer ways to cope. A caring, calm, and curious response can help strengthen trust and connection.

Show you care: Tell your young person you love them, that you are concerned, and that you want to understand how you can support them.
Acknowledge their feelings: Let them know their feelings matter. Ask what they are experiencing and what might help them feel supported, especially when urges to self-harm become strong.
Validate before problem-solving: Before offering solutions, first try to understand and acknowledge what your young person is feeling. Feeling understood can help reduce emotional intensity and create space for problem-solving.
Learn basic first aid: Offer basic first aid for injuries and seek medical care when needed. Try to respond calmly and without criticism or shame.
Build trust: Avoid reactions that communicate disgust, anger, guilt, or blame. Listen with curiosity and focus on understanding what they are going through.
Encourage safer coping strategies: Support your young person in using alternatives that can help manage intense emotions and urges to self-harm, such as talking with someone they trust, using grounding skills, physical activity, creative activities, listening to music, or other calming activities. You can help by making these strategies easier to access, offering reminders when needed, and participating with them when they would benefit from support and connection.
Be patient: Recovery takes time. Telling a young person to "just stop" is usually not helpful and does not address the reasons self-harm is happening.

Important: Helping a young person stop self-harm involves more than removing the behaviour. It also means helping them develop safer coping strategies and supports that address the emotions and situations contributing to self-harm.

When to get help

Contact your care team if:

Self-harm behaviours continue or increase.
Your youth is struggling to cope with stress or emotions

Go to the Emergency Department or call 9-1-1 if:

Your youth is at immediate risk of harming themselves.
Injuries require urgent medical care

In emergencies, contact a crisis line or call 911.

Contact your care team or a mental health professional if:

Your young person is self-harming repeatedly, or the behaviour is increasing in frequency or severity.

Your young person is having difficulty managing strong emotions, stress, or urges to self-harm

You are concerned about your young person's safety or need support understanding how to respond.

Seek urgent help by going to the Emergency Department or calling 911 if:

Your young person has thoughts of suicide and feels unable to stay safe.

Your young person has made a suicide attempt.

Injuries require urgent medical attention.

You believe there is an immediate risk of serious harm.

If you are unsure what to do, contact a crisis service for guidance and support.

Helpful resources

YSB (Youth Services Bureau of Ottawa)

24/7 Crisis Line: 613‑260‑2360 Toll‑free (Eastern Ontario): 1‑877‑377‑7775
Mental Health Services: 613‑562‑3004
2675 Queensview Drive, Ottawa, ON K2B 8K2
info@ysb.ca

PLEO – Parent’s Lifelines of Eastern Ontario

613‑321‑3211
Outside Ottawa: 1-855‑775‑7005

info@pleo.on.ca

Helpline hours vary by day (daytime and evening support)

Kids Help Phone

1-866‑668‑6868

YouthNet (CHEO)

2305 St. Laurent Blvd., Unit 300B, Ottawa, ON K1G 4J8
613‑738‑3915
youthnet@cheo.on.ca

Additional information

Additional information

Positive parenting and guardianship: Children and youth do best with an authoritative (“backbone”) approach that balances structure, care, and flexibility.

Too permissive (“jellyfish”): few rules, low protection, limited involvement
Too authoritarian (“brick wall”): too many rules, overly strict, overprotective
Authoritative (“backbone”): clear rules, emotional support, healthy communication

If your youth threatens self-harm, some youth may use self-harm threats to avoid consequences. If rules are fair, do not give in, as this reinforces unhealthy behaviour. Maintain limits while also offering emotional support and reasonable adjustments if your youth is overwhelmed.

Additional information

The terms non-suicidal self-injury (NSSI) and self-injurious behaviours (SIB) are sometimes used when discussing self-harm. These terms refer specifically to intentional self-injury without the intention to end one's life. However, it is important to remember that any self-harm should be taken seriously and understood within the context of each young person's experiences.

We hope this resource has provided helpful information to better understand self-harm as a way some young people try to cope with overwhelming emotions or difficult experiences. With support from caring adults, healthcare providers, and mental health professionals, young people can learn safer and more effective ways to manage distress, build coping skills, and move toward recovery.

Need Help Right Now?

CHEO’s Emergency Department is open 7 days a week, 24 hours a day and cares for children and youth aged 0–18 years. Want to talk with someone? Call Health811 (dial 8-1-1) to speak with a nurse 24/7.

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Disclaimer

These resources are for educational purposes only. If you have questions, speak with your health care provider. Last updated: June 2026