Self Injury / Self Harm

General Information

The act of deliberately harming one’s own body by means such as cutting or burning is referred to as self-injurious behaviour (SIB) and is used as a way of coping. Self-injurious behaviour is an attempt by a child to

  • escape from feelings of numbness (some say that they injure themselves to feel something or to know that they are alive)
  • draw needed attention, support, or signs of caring from others
  • feel in control (e.g., control over one’s body, control over others)
  • turn intense, unmanageable emotional pain into physical pain
  • escape from feelings of emptiness and depression
  • relieve tension

For children who believe their distress is invisible, self-harm is a way of creating physical proof of their emotional pain and of maintaining hope that it will be noticed and addressed. For others, the physical pain from self-harm can be a way to distract themselves from the emotional pain they feel. Many of these children may not have learned healthy ways of identifying and expressing overwhelming negative emotions, such as intense anger, tension, or frustration; they find temporary relief from these distressing feelings through harming themselves.

Other mental health difficulties often occur alongside SIB, and a successful approach to freeing a student from it needs to address these difficulties as well, improve coping skills and practices, and resolve the underlying distress.

General Characteristics To Look For

Children dealing with psychosis may

  • refuses to wear short sleeves or to change clothing for physical education classes
  • wears long sleeves or long pants even in hot weather
  • keeps sharp objects on hand
  • claims to have frequent accidents or mishaps
  • cuts or wounds don’t seem to heal
  • often bruised
  • has more than his/her share of broken bones
  • spends a great deal of time alone
  • voices concerns that he/she is patronized, that others do not listen

Impact On Student Success

When students feel that the school environment adds to their feelings of distress and isolation or are embarrassed about their self-injurious behaviour, they may avoid attending school.

  • Provide appreciative support for children when they are not engaged in self-injurious behaviour to build trust and help them believe that they can anticipate and rely on support.
  • Let children know that they are by no means alone.
  • Provide a lot of support and encouragement as children develop new coping strategies.
  • When homework or school work is clearly overwhelming, make temporary adjustments.
  • Recognize that any one teacher or support staff member cannot meet the needs of a student with SIB but consistently respond with empathy and validate the student’s need for care and connection.
  • Approach the principal with your awareness of the student’s needs.
  • Students who self-harm are more sensitive to criticism and require praise and support.
  • Share the task with other staff of giving the time and support needed to break down the student’s feelings of isolation.
  • Build partnerships and follow protocol with community agencies that can assist in supporting students.
  • Support and facilitate student engagement in vital areas of school life such as drama, sports, clubs, etc.
  • Encourage the student to seek medical attention if wounds are infected.
  • Help facilitate connections to community mental health supports.
  • Provide professional development opportunities for staff.
  • Seek information to help build an understanding of self-injurious behaviour in general.
  • Consider how to provide some extra care and attention for the child.
  • Consider how the family models the management of distressing emotions and work to build effective communication and acceptance.
  • Support referrals to child mental health services and work closely with the treatment team.
  • Provide consultation and support to schools and families about how to practise effective coping skills with the child so that he/she can function successfully at school and in the community.
  • Assess the need for and provide treatment of underlying distress.
  • Facilitate referrals for specialized consultations and treatment as needed.
  • Help the family assess its ability to model effective communication and support for one another.
  • Help the child express and identify feelings and at the same time develop healthy coping skills.
  • Engage in ongoing joint training initiatives.
  • Focus on “UPSTREAM” prevention initiatives.