Self-Harm + Young People

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au

Self-harm is when someone deliberately hurts or mutilates their body without meaning to die, although death may still occur as a result of the self-harming behavior.

Self-harming is a behaviour and not in itself a diagnosable mental disorder. Self-harm often occurs in young people who experience depression, anxiety, behavioural problems (such as conduct disorder) and substance use.

Facts about self-harm:

Not all people who self-harm are suicidal, but it can be a sign that they are thinking of suicide.
Self-harm often begins during youth and can be a way of communicating how bad someone feels or a method of coping with intense pain or distress.
Around 1 in 6 young people have engaged in self-harm at some point in their lives and around 1 in 15 during a 12-month period.
Support and treatment can help a young person learn safer and more helpful strategies for managing their distress and increasing their coping skills.
Treatment for an underlying mental health problem (e.g., depression, anxiety) can also help in reducing or stopping self-harming behaviours.

What to look for?

There are many different types of behaviours that can be considered self-harming. The most common behaviours include self-cutting (e.g. cutting of upper arms/wrists/thighs) and self-poisoning (e.g. deliberately swallowing excessive amounts of prescribed or illegal drugs). Young people may also engage in self-burning (e.g. using cigarettes or lighters to burn the skin).

There are other behaviours that are not formally considered to be self-harming behaviours but are “risk-taking” behaviours that can lead to personal harm. Some examples are train-surfing, driving at high speed, illegal drug use, or repetitive unsafe sexual practices despite knowing about safe sex practices.

What causes self-harming behaviours?

People self-harm for different reasons, and sometimes it can be difficult to put the reasons into words. In many instances when someone engages in self-harming behaviour, it is an attempt to relieve, control or express distressing feelings. Some people who self-harm may not know other ways of telling people about their emotional pain, and some may feel a sense of control over pain when they self-harm.

Research suggests some people are more at risk of self-harming. This includes people who have experienced emotional, physical or sexual abuse, or stressful and highly critical family environments, or experience mental ill-health, such as depression.

People self-harm for different reasons, and sometimes it can be difficult to put the reasons into words.

What can young people do if they are engaging in self-harm?

Try to talk to someone about it. Telling a trusted adult can help to make sure the young person is safe and that medical assistance is received, if needed. If a young person repeatedly engages in self-harming behaviours, it is best to get some psychological treatment (counselling). One aim of counselling is to help the young person to feel better and find safer and more helpful ways of coping. Young people who are having suicidal thoughts should see a professional or call their local hospital or a help line, such as Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777 or Hospital Authority Mental Health 24-hour Hotline: 2466 7350. (For more Hong Kong hotlines please refer to ‘Further information’ section at the end of this article.)

Counselling usually involves helping to increase problem-solving, communication and coping skills. Sometimes this can take time, so it’s best for young people to keep at counselling even if they think it’s not helping the first couple of times. It can be difficult to accept counselling after self-harming because of feelings of guilt, anger, or shame. Trying to be open to counselling or support can assist young people in feeling less overwhelmed and stressed in the long run.

Helping a young person who self-harms

Some people just stop self-harming, others can continue in a way that minimises physical risks, and others can place themselves at risk of dying. Even when self-harming behaviours stop, young people can experience long-term consequences associated with shame, guilt or coping with physical reminders, such as scarring. The best way to help someone you know that is self- harming is to encourage and support them to seek professional help as early as possible, to try to prevent longer-term consequences and to get the right help for any underlying mental health problems. Some things to do are:

Try to help the young person feel safe to discuss the self-harm.
Try to remain calm and maintain an open attitude recognising the young person may feel ashamed of their actions.
Don’t be critical or get angry when discussing these issues.
Ask the young person whether they feel suicidal. Call your local hospital or mental health service if you think the young person is suicidal to get professional help. Remember that someone’s risk does not always stay the same, so it is best to check in with them regularly.
Supporting someone who self-harms can be a stressful experience and getting support for yourself is also recommended.

Really worried?

Initial treatment involves dealing with any immediate medical complications of self-harm, if present. Call an ambulance (999) or take the person to the accident and emergency department of the nearest hospital if the person needs urgent medical attention.

The best way to help someone you know who’s self-harming is to encourage and support them to seek professional help.

The best way to help someone you know who’s self-harming is to encourage and support them to seek professional help.

Advice and referral

If you know a young person who is repeatedly self-harming and you are not sure what to do, contact someone with experience in this field and discuss the situation with them.

If a young person refuses referral for further support, you need to discuss your concerns with them. Family members may find it helpful to let the young person know that they respect the young person’s wishes, but that they also care about the young person and need to discuss their concerns with a professional.

Workers need to explain the boundaries of their relationship with the young person and the limits of confidentiality. If the young person continues to be at risk and requires more care than the worker feels capable of providing, the worker should discuss the situation with a colleague and refer to a mental health professional or service.

Further information

For further information regarding mental health, or for information in other languages, visit:

Australia / International

Hong Kong

The Samaritans

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 28960000
Samaritan Befrienders Hong Kong 24-hour hotline: 23892222
Suicide Prevention Services 24-hour hotline: 23820000
Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777
Hospital Authority Mental Health 24-hour Hotline: 2466 7350
Social Welfare Department Hotline: 2343 2255
Chinese-Only Telephone Hotlines
Youth Outreach 24-hour hotline service: 90881023
The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899

Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.