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Text or call the Suicide Crisis Line 988

Go to your closest emergency department

Call 911

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The information in this binder is for group use only. Included pages have been adapted for educational purposes only. DO NOT copy, distribute, or sell. 

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The information in this binder is for group use only. Included pages have been adapted for educational purposes only. DO NOT copy, distribute, or sell. 

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How to Talk to Your Kids About Self-Harm at Every Age

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When parents hear about self-harm, it can be tempting to ignore the topic or assume that it could never happen in their family. But, unfortunately, self-harming behaviors are occurring more frequently than you might imagine and should be added to the list of things you need to discuss with your kids.

"Self-harming or what we in the mental health world label as Non-Suicidal Self Injurious (NSSI) behaviors are unfortunately very common," says Dean Aslinia, PhD, LPC, NCC, the associate dean at the University of Phoenix College of Social and Behavioral Sciences Psychology and Human Services. "Research has indicated up to 20% of adolescents engage in these behaviors. While these behaviors tend to start around the age of 13 to 14, broadly speaking the greatest risk comes when the child is old enough to have access to or purchase the means of self-harm."

Most experts agree that the topic of self-harm is not something you should ignore-especially if you suspect that your child might be at risk for self-injury. But that can feel difficult when you're not sure what self-harm could even look like.

"What I can't stress enough is the need for honesty and awareness," says Laurie Singer, MS, LMFT, BCBA, a licensed psychotherapist, a board-certified behavior analyst, and a family/child therapist. "Many of the children I've worked with have been self-harming for years-yet their parents never noticed."

Here's how mental health professionals suggest talking about self-harm with your kids based on their age.

What Parents Need to Know About Self Harm

For most young people, self-harm is an attempt to interrupt strong emotions and pressures that feel overwhelming or impossible to tolerate. In most cases, kids who self-harm have not learned other coping strategies so they turn to self-injury as a form of release. It also can lead to intense feelings of guilt and shame.

"Self-harm can serve several different functions [for kids]," explains Leslie Crea-Kammerer, PsyD, a clinical psychologist at Advanced Psychology Services. "One of the most common is it serves as a release for tension or intense feelings. On the flip side, others use self-injury because they feel numb and it is a way for them to feel something. It can be a relief to feel anything, even something painful, versus feeling numb or disconnected."

Young people may even use self-injury as a way to feel more in control, says Leigh McInnis, LPC, a licensed professional counselor and executive director of Newport Healthcare Virginia. Triggers for self-harm can include things like exam pressures, attempting to cope with difficult family relationships, caring for siblings with physical or mental health issues, bullying, abuse, trauma, or exposure to self-harm by peers, she says.

"Parents need to know that self-harm is not a mental illness, but rather a maladaptive behavior resulting from a lack of healthy coping skills," says McInnis. "Self-harm is a child's way of communicating that they are in emotional distress and that they need to learn healthier coping skills."

Should You Talk to Your Kids About Self Harm?

When it comes to talking to kids about self-harm, parents sometimes worry that bringing up the subject will put the idea in their child's head. The truth is, though, your child is going to hear about self-harm at school, through their peers, and on social media. But, if you are the one talking about the topic, you can debunk any myths, make sure your kids have the facts, and establish that they can talk to you about anything.

"Kids are going to have access to social media and friends at school even if we try to shelter them from unpleasant topics," says Kristen Souza, LMHC, a licensed mental health counselor with experience in parenting, anxiety, trauma, panic attacks, and more. "Letting your kids know that they can come to you about anything is the moral of the story. You also want them to come to you if they suspect a friend or peer engaging in self-harm and know that you will be able to help."

Keep in mind, though, that self-harm does not necessarily mean a person is suicidal or wants to die, says Dr. Crea-Kammerer. Likewise, she says this is not often a behavior that kids will "grow out of."

"People who self-harm frequently think about doing it or feel the urge to do it, even when they are not engaging in the behavior," she says. "Also, the more shame and guilt they feel around it, the more likely they are going to be to want to keep it hidden and not address it."

For this reason, parents need to not only talk about self-harm in an open and honest way but also learn to recognize the signs of NSSI behavior, says Dr. Aslinia. Sometimes parents do not realize their kids are engaging in self-harm until the injuries become severe and require hospitalization, he adds. Talking about the topic may help prevent kids from self-harming. It can also give you a chance to bring the issue to the surface, allowing you to connect your child with a mental health professional.

Potential Signs of Self-Harming Behaviors

According to McInnis, parents should investigate further if they notice any of these potential signs of self-harming behaviors and get the help of a mental health professional for their child.

Unexplained cuts, scratches, bruises, or other wounds, often on the wrists, arms, thighs, or torso, which they may explain as the result of accidents

Wearing clothes that cover up the skin, such as long sleeves or long pants, even in hot weather

Impulsive and unstable behavior

Expressing feelings of hopelessness or worthlessness

Blood stains on bedding, clothing, towels, or tissues

Having sharp objects in their possession, including razors, safety pins, nail scissors, knives, needles, shards of glass, or bottle caps

Spending long periods of time alone, often in the bathroom or bedroom

Increased isolation and social withdrawal

Avoiding situations in which they need to reveal skin, such as swimming or changing in a locker room

Talking About Self Harm With Preschoolers

Preschoolers may not understand the concept of self-harm, so you need to consider your word choice and opt for age-appropriate terms. For instance, you might talk about the idea that sometimes people hurt themselves when they are upset-like a classmate that bangs their head against the wall or pulls their own hair.

Explain that there are other ways to deal with these big emotions rather than hurting themselves. Then, talk about strategies for coping with their feelings in a healthy way. You may even try role-playing how to handle something that makes them angry or sad.

"[With preschoolers], I recommend starting with basic conversations about feelings-what we feel and how we feel it in our bodies, how we express feelings, and how we try to manage feelings in different ways," says Dr. Crea-Kammerer. "If preschoolers engage in self-harmful behaviors when upset or observe another child doing so, it is a great opportunity to acknowledge that sometimes people do that because they have very big feelings."

It is also important to be honest with your child-never lie or hide pertinent information, even though they are young, says Dr. Aslinia. This doesn't mean that you scare them or provide more than they need to know, but you should not try to shelter them.

"While a parent may feel they are 'protecting' their child from unhealthy information, they are likely to come across this knowledge from their peers. Unfortunately, this information is often laced with mis information," says Dr. Aslinia. "It's much more productive for parents to provide correct and helpful information [in an age-appropriate way]."

Where you can make the biggest difference at this age is teaching your child how to handle feelings like sadness, anger, loneliness, and frustration, says Singer. Also, let them know that having emotions is part of being human.

"When we're young we often feel that everything that's happening to us is only happening to us," she adds. "We don't have the breadth of experience to understand that certain feelings aren't unique. Oftentimes, it's just a matter of providing [your] child with the tools to calm down when they're feeling out of control and [teaching them] to put things in context."

How to Talk About Self Harm With Grade Schoolers

By the time your kids are in grade school, they may have heard about self-harm on the news, on the Internet, or through a friend. With this in mind, you can test out the waters. Broach the topic by asking your child if this is something they have heard of or seen, says Singer. You also could try reading something together on the topic and then discussing it in a non-judgmental way, she says.

"If you want to assess their awareness about [self-harm], approach the topic with curiosity and questions," suggests McInnis. "Choose a time and place when you know your child is comfortable talking freely, such as during a family meal or while in the car after school pick-up."

She also recommends bringing the topic up more than once so your kids have time to think about it and process their own reactions. Use terms that your child can understand and discuss self-harm in a nonjudgmental and caring way.

"Maybe say that some people engage in self-harm because they don't know how to manage what they are feeling inside," she suggests. "Then, discuss the ways you and they can deal with unpleasant emotions in a healthier way, like taking deep breaths or going for a walk outside."

With grade schoolers, Dr. Aslinia recommends parents establish a routine practice of asking their children how they are feeling and what they are hearing or learning at school. Doing so may open the door to a deeper conversation. It also allows you to gauge how your child is feeling and if there is anything that needs to be addressed.

"I always say a good time to bring up tough topics is when a real-life example presents itself," says Souza. "If you notice your child experiencing big feelings and you feel comfortable with their level of understanding, bring it up. [Say something like] 'I know you're feeling sad right now and it's OK to feel sad sometimes. What can you do when you're sad to feel better?'"

Talking With Your Preteen or Teen About Self Harm

By the time your child is a preteen or teen, they are likely familiar with self-harm. They may have even considered it themselves. Consequently, when talking to them about the behavior, limit the lectures and judgment. Instead, strive to be calm and conversational, says McInnis. Lead with curiosity and ask questions.

"Tell them you read an article about self-harm and wondered if they knew what it was," she says. "Talk to them about why people do this and [offer] some of the healthier ways we can manage our feelings and emotions. Ask them what they do when they get upset."

Also, actively listen to what your child is saying, avoid interrupting them, and let them speak freely without reacting, says Singer. This approach is especially important if your child has thought about self-harming or if they admit to self-harm.

"The most important part of any conversation from a parent to a child should always communicate care and love," says Dr. Aslinia. "Meaning, whatever questions or information the parent is sharing with their child, it should always communicate to the child that the parent loves them and wants to ensure their safety and healthy environment [so they can] continue to thrive."

He also suggests being careful not to shame or bring about feelings of guilt. Validate their feelings and refrain from punishing them. Instead, find them the help they may be seeking. And, do not be afraid to ask hard questions or even talk about self-harm, he says.

"[But do not] ask 'why' questions, as they will seldom produce the explanations you are looking for," Dr. Aslinia says. "Instead, ask what you can do to help them feel better."

And finally, remember that avoiding conversations about self-harm is unlikely to shield your preteen or teen. It's more likely to allow them to develop more difficult feelings or beliefs related to the practice on their own, adds Dr. Crea-Kammerer. Not talking about it could lead them to view it as something shameful to keep hidden.

"It is always better for a child to learn from their parent about the risks of self-harm and alternatives to this form of coping than to learn from a peer who may be engaging in this behavior, or from social media where the behavior may be glorified," says McInnis.

Additional Questions to Ask

According to Dr. Aslinia, there are some additional questions to ask leading up to assessing concerns for self-harm in a child. Those might include:

Is anything worrying you?

Is there anything making you scared or concerned?

Are you feeling sad?

Have you been or seen someone be bullied?

Do you feel safe?

A Word From Verywell

Discussing self-harm can feel challenging and overwhelming at times. But rest assured that it is not what you say as much as how you say it. As long as you are communicating love and support to your child as well as establishing that you are someone they can trust, you will accomplish your goal. Likewise, you may be able to prevent self-harming behaviors in your kids by having conversations early and teaching them to recognize their feelings and cope in healthy ways.

If despite your efforts, you find that your child is still struggling with managing their emotions, you may want to talk to their pediatrician or connect them with a mental health professional. These practitioners can help your child learn healthy methods of coping so they do not resort to harming themselves in some way.

Additional Reading

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How to Talk to Your Kids About Self-Harm, According to Experts

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When parents hear about self-harm, it can be tempting to ignore the topic or assume that it could never happen in their family. But, unfortunately, self-harming behaviors are occurring more frequently than you might imagine and should be added to the list of things you need to discuss with your kids.

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Find Your Words is designed to make it easier to open up about mental health and empower more people to ask for help, take action to help themselves, and support others.

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Mental health matters, and we should talk about it - just like we talk about physical health.

Find Your Words is designed to make it easier to open up about mental health and empower more people to ask for help, take action to help themselves, and support others.

As one of the nation's leading health care providers and nonprofit health plans, Kaiser Permanente understands the connection between mental and physical health, and the importance of caring for the whole person.

Now more than ever, we all need support to stay balanced, build resilience, and feel mentally and emotionally strong - whether it's clinical care, social support, or simply practicing self-care.

Together, we can create a culture of acceptance and support - and help end stigma for good.
Learn more about mental health and wellness at Kaiser Permanente

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Safety Recommendations to be followed while in IOP

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Parent/Guardian to remove sharps and other items that could be used for self-harm; Common sharps include knives, scissors, razors, and blades. Common additional items include rope, house cleaner chemicals, and other toxic chemicals.
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How to Ask Your Teen Questions about Suicide and De-escalation Techniques

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How To Ask Your Teen Questions About Suicide

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How To Ask Your Teen Questions About Suicide

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How to Talk to your Kids About Suicide at Any Age

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Suicide is a public health crisis that affects families around the world, but how do you talk to kids about suicide? Suicide is the third leading cause of death for adolescents and the fourth leading cause of death among people aged 35 to 44. According to the World Health Organization, more than 700,000 people die by suicide each year. That means one life is lost every 45 seconds-or 1,917 lives are lost each day.

While the causes of suicide are varied and complex-substance use disorders, bullying, financial troubles, trauma, and mental illness have all been linked to suicide-it is an issue that can affect both children and adults. But many parents are wary about broaching such a serious and sensitive topic with their kids.

One common worry is that talking about suicide with kids will "put ideas in their head" or cause suicide. But according to Alicia Raimundo, a mental health advocate and project manager of Foundry, an online health and wellness resource for teens and young adults aged 12 to 24, the opposite is true.

Instead, these conversations help people dealing with thoughts of suicide understand that they can find support and they aren't alone in their thinking. "It also helps them see that they are loved and people want them to stay in their lives," adds Raimundo.

So, where do you start? Here are some expert insights on how to talk to kids about suicide.

How to Talk to Young Children About Suicide

While some believe that it's best to wait to talk to very young children about topics like suicide, the reality is that even very young children will hear about tragedies, and it's important for them to hear from you. "If a child has been exposed to suicide, you need to talk to them about it, regardless of their age," says Lyn Morris, LMFT, chief executive officer for Didi Hirsch Mental Health Services, which provides free help for mental health issues, substance use disorders, and suicide prevention.

Preschool and kindergarten

For preschool- and kindergarten-aged children, it is important to stick to the basics. "I would recommend talking to them about someone [dying] from suicide like you would any other disease," says Raimundo. Use clear, concise words, like "I have some news to tell you. Uncle John died." Avoid euphemisms but also avoid giving lots of details. Encourage questions and feelings, and accept their reaction to the news. Some children will cry while others will seem indifferent. Both reactions are OK and normal.

Elementary-age

For children aged 8 to 11, Raimundo suggests emphasizing the sadness of the death and giving them details they will understand. "Explain the act was caused by an illness called anxiety, depression, [addiction], or trauma," says Raimundo. Let them know these illnesses are treatable in most cases, but for some, mental illness can be fatal. And as with younger children, encourage any and all questions and feelings.

Gail Saltz, MD, a psychiatrist and associate professor of psychiatry at the New York Presbyterian Hospital Weill-Cornell School of Medicine, says that a great way to initiate a mental health conversation is to discuss emotions: "It is never too early to talk about feelings, which is really a youth-based way to talk about mental health," says Dr. Saltz. Ask them if they feel sad, mad, or nervous. It's important for anyone, especially children, to be able to label what they feel and be comfortable enough to open up about their emotions.

But if a young child is displaying warning signs-such as changes to their sleeping patterns, changes in their behavior, or increased withdrawal-a different conversation is necessary. The American Foundation for Suicide Prevention recommends asking elementary-aged children how they feel but taking it a step further: "If it seems to you that they feel hopeless, trapped, or overwhelmed then ask if they ever think about hurting themselves or ending their life," the organization shares on its website.

How to Talk to Tweens and Teens About Suicide

By high school, many kids have been exposed to suicide -whether they've seen it spoken about on TV, had a person or friend close to them struggle with it, or had suicidal thoughts themselves. The older they are, the more direct you need to be.

Start by asking your teen what they know or have heard about suicide. Gather information, present facts, and dispel any myths, including the idea that those who take their own life are selfish and weak. Answer questions they may have without shame, judgment, or fear.

It's also a good idea to help adolescents come up with a plan of what they'll say or do if the topic of suicide comes up in their social circles because chances are it will, says Raimundo. Teach children the best way to support their friends who express suicidal thoughts is to ask a safe adult for help, even if it means going against their friend's wishes.

Always remind them help is available if they ever find themselves in that position. Validate their feelings by saying things like "That must be hard" or "It sounds like you're dealing with a lot." Suggest people or places they can turn to if they are ever having suicidal thoughts. Always keep in mind: "The best time to talk about suicide with your kids is when they're not in a crisis," says Morris.

So what can we do to prevent suicide? We can talk about it with our family, friends, colleagues, peers, and children. Because talking about suicide removes the stigma surrounding it. It lifts the veil of secrecy. It also makes the topic accessible. If your children learn about suicide from you, they will know how to discuss the topic if it arises in the future.

Resources for Suicide Prevention

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Talking with your child about suicide can be difficult, but it is essential and may even be life-saving. Here's how to talk to kids about suicide.

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What to say to someone who is depressed

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