Teen Mental Health: Self-Harm

two teen girls smoking self harm up against a yellow wall
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From the outside looking in, self-harm can be a frightening and puzzling behavior – and one that’s difficult to understand. It may be surprising to learn that it’s not always driven by suicidal tendencies. In fact, teens that self-injure probably don’t intend to die but rather use it as a coping mechanism.[1] However, studies have shown that teens and tweens who engaging in self-harming behavior have a higher mortality rate.[2] For these reasons and many others, it’s important to know both how to identify symptoms of self-harm and how to address them.

What is self-harm?

Psychology Today defines self-harm as “the act of deliberately inflicting pain or damage to your own body.[3]” If a teen or tween is scratching, cutting, hitting, biting or burning themselves to cause pain, these would all be considered signs of self-harm. However, less talked about forms of self-harm can include deliberately ingesting toxic levels of alcohol or drugs or participating in other risky behavior, such as unprotected sex. Statistics indicate about 17% of teens and tweens will engage in self-harming behavior at least once.[4] And while girls may develop self-harming behaviors earlier, adolescent boys are responsible for the overall highest incidences of self-harming behavior.[5]

What causes self-harm in teens and tweens?

Adolescents are undoubtedly struggling with a difficult time, and with the rise in cyberbullying and ongoing school bullying, it’s easy to question if school climate and other situational triggers factors can be the culprit behind self-harming behaviors. Pediatricians are often reluctant to isolate any one cause, though. In some cases, self-injury can be soothing to teens with underlying mental health issues.[6] Teens or tweens also may engage in self-harm as a way to communicate an unmet need to parents or peers.[7] A school climate survey can help you learn more directly from students about what may be troubling them.

How to look for symptoms of self-harm in teens and tweens

According to the Mayo Clinic, common symptoms of self-harm include:

• Scars, often in patterns
• Fresh cuts, scratches, bruises, bite marks or other wounds
• Excessive rubbing of an area to create a burn
• Keeping sharp objects on hand
• Wearing long sleeves or long pants, even in hot weather
• Frequent reports of accidental injury
• Difficulties in interpersonal relationships
• Behavioral and emotional instability, impulsivity and unpredictability
• Statements of helplessness, hopelessness or worthlessness[8]

When considering self-harm through excessive alcohol consumption or illicit drug use, however, student perceptions can complicate symptoms. While the Centers for Disease Control define binge drinking as having more than four or five drinks[9], a student survey from Pride Surveys suggests almost 32% of students do not believe consuming five or more drinks once or twice per week puts them at risk of harming themselves.[10] So, it’s important when talking to teens and tweens about self-harm to discuss whether they are aware of the harmful effects of excessive consumption.

How to approach teens or tweens who may be engaging in self-harm

When addressing any issue related to teen mental health, it’s always best to begin with empathy. Worry less about “why,” and focus more on how you can help the individual feel heard and cared for.[11] Approaching them privately and in an environment where they already feel safe is the best method.  A student survey conducted by Pride Survey found that at school middle and high school students feel safest when in the classroom[12].

Depending on the severity of the self-harm, you may not feel that you have the skills or training to address the behavior. If that is the case, it’s best to engage a mental health professional. And if you believe that someone is in imminent danger, do not hesitate to take them to a healthcare professional or the emergency room. The National Suicide Prevention Lifeline (1-800-273-8255) offers free, 24/7 support that is completely confidential[13]

Since 1980, Pride Surveys has been providing research-quality data for schools and communities to study student mental health. Our Social, Emotional and Bullying Behavior Survey (SEBBS) collects data that assess problem behaviors that affect student engagement such as increased absenteeism, lower academic achievement and increased substance abuse. The Pride Surveys Learning Environment Survey is also recommended as a student evaluation tool for grades 6-12 because of its powerful reporting system and examination of current issues in education such as student mental health, bullying, teen suicide, student learning and more.

The benefit of working with a survey company is that we can gather fact-based data and information through anonymous and effective survey tools. With this information, educators, parents, PTAs and community coalitions are in a better position to address mental health issues in their schools and secure future funding from a variety of sources to support their programs.

Please browse through the different types of student surveys we offer and find out why more than 14 million students, parents, and faculty members have responded to Pride Surveys. Questions? Please call us at 800-279-6361 or contact us today.




[1] “Understanding Self-Injury/Self-Harm.” Retrieved 30 January 2019 at http://teenmentalhealth.org/understanding-self-injury-self-harm/

[2] “Suicide After Deliberate Self-Harm in Adolescents and Young Adults.” Retrieved 30 January 2019 at http://pediatrics.aappublications.org/content/141/4/e20173517

[3] “Self-Harm.” Retrieved 30 January 2019 at https://www.psychologytoday.com/us/basics/self-harm

[4] “Who self-injures?” Retrieved 30 January 2019 at https://www.apa.org/monitor/2015/07-08/who-self-injures.aspx

[5] “Self-Harm.” Retrieved 30 January 2019 at https://www.psychologytoday.com/us/basics/self-harm

[6] “Chapter 191: Self-Harm.” Retrieved 30 January 2019 at https://pediatriccare.solutions.aap.org/chapter.aspx?sectionid=109663654&bookid=1626

[7]“Chapter 191: Self-Harm” Retrieved 30 January 2019 at https://pediatriccare.solutions.aap.org/chapter.aspx?sectionid=109663654&bookid=1626

[8] “Self-injury/cutting.” Retrieved 30 January 2019 at https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950

[9] “Fact Sheets- Binge Drinking.” Retrieved 30 January 2019 at https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm

[10] Pride Surveys Questionnaire for Grades 6 thru 12 2016-17, Pride National Summary, October 19, 2017

[11] “Self-injury/cutting.” Retrieved 30 January 2019 at


[12] Pride Surveys Questionnaire for Grades 6 thru 12 2016-17, Pride National Summary, October 19, 2017

[13] “National Suicide Prevention Lifeline Homepage.” Retrieved 30 January 2019 at https://suicidepreventionlifeline.org/

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