A study revealed that nearly a quarter of young people engage in self-harming activities. We explain what self-harm is and suggest ways to look out for affected youths and help them navigate their anxiety and stress.
As a parent or friend, finding out that your child or someone dear to you has been self-harming and is in distress can be upsetting. But it is good to keep in mind that it takes courage for a young person to open up about their emotional distress and self-harm behaviour. Hence, family and friends need to manage their own emotions before initiating any conversation.
Before reaching out, take a step back and understand what self-harm is. As the name suggests, it is the act of deliberately causing physical injury to oneself, such as cutting or burning. This type of self-injury is a harmful way to cope with emotional pain, intense anger or frustration. While it may bring a momentary sense of calm and a release of tension, it is usually followed by feelings of guilt and shame and the return of painful emotions.
According to Dr Tammy Tsang, Consultant, Department of Psychiatry at SKH, deliberate self-harm is a significant clinical problem especially among younger people in Singapore. A study done on 542 adolescents seen at a psychiatric outpatient clinic in Singapore saw 23.6% of them engaged in deliberate self-harm.
On a national level, suicides and self-harm amongst adolescents are on the rise. Figures from Samaritans of Singapore (SOS) show that youths aged 10 to 29 years old made up nearly one-quarter of the 452 suicides reported in 2020.
While life-threatening injuries are not usually the intention, the act of self-injury increases the risk of a more serious or even fatal self-aggressive actions. It is possible for affected youths to have both self-harm behaviour and suicidal thoughts and it is recommended to approach and explore this topic in a gentle manner.
Teenagers generally need to feel emotionally safe before they can start to open up as they may be ashamed of their self-harm. Here are some tips on broaching the topic:
Adopt a direct, calm and non-judgmental tone. This helps to address a teenager’s concern of how people would react to their replies.
Practise empathic listening where you listen in a way that encourages the other person to talk. Do this by creating a safe space for discussion without interruption. This is crucial as adolescents often feel unheard and misunderstood.
"I can see that you are struggling. How can I help you?"
"This may be a difficult topic, but I noticed the scars on your arm. Could you tell me about the times when you hurt yourself?"
Professional help can be useful for both affected teenagers and families. It can give youths the option of having their own space with a professional to figure out how to manage their distress, and family members can get tips on self-care and how to support their loved ones.
Strong suicidal intent or plan, or a recent suicide attempt
Changes in mood, sleep, appetite or behaviour
High frequency, intensity and lethality of self-harm acts
There are several treatment therapies that can be personalised accordingly to their needs, such as psychological therapy, counselling or family therapy. These talking therapies work towards helping the teenager understand and identify triggers, as well as manage their intense emotions as an individual or within a family system.
A referral for formal psychotherapy, or talk therapy, may be helpful for adolescents to address underlying psychological issues and to develop more effective coping skills in regulating emotions and tolerating distress. A review by a doctor can also help in evaluating for any underlying mental health disorder and in such instances, medications may be a consideration.
Schools also have access to REACH (Response, Early intervention and Assessment in Community mental Health), a mental healthcare service that works closely with schools, social service agencies, and general practitioners to address the mental health needs of students.
If your child is uncomfortable seeing a healthcare professional in person for advice, you can suggest online or phone options, such as the following helplines:
IMH Mental Health Helpline: 6389 2222 (24 hr) Samaritans of Singapore: 1800 221 4444 (24 hr) Community Health Assessment Team (CHAT): 6493 6500Tuesday to Saturday, 1pm to 8pm (excluding Public Holidays) Family Service Center: 1800 838 0100Monday to Friday, 9am to 5pm
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