Self-injury - Mental Health

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  1. Deliberate, self-inflicted harm
    1. Self-injury (or non-suicidal self-injury) is deliberately self-inflicting harm to one’s own body without the intention of suicide. 
  2. Prevalent across several demographics
    1. While self-injury is sometimes depicted as an issue most relevant to middle- to upper-class white women, there are similar rates of prevalence across racial and ethnic groups, genders, and socioeconomic status. Self-injury is most often seen in teenagers and young adults.
  3. Indicates the need for a coping mechanism
    1. People who self-injure most often use the behavior as a coping mechanism, and treatment usually involves developing a more effective set of coping strategies. 
  4. Contagion risk in storytelling
    1. Seeing the act of self-injury can trigger similar impulses in viewers who are currently or have previously self-injured. Avoid showing cutting, burning, or scratching, and scars or injuries related to these acts to limit the risk of contagion.

Storytelling Tips

Diversify Representation
  • Expand representation so people who are dealing with self-injury can see themselves reflected. 
  • Data shows similar rates of self-injury prevalence across racial and ethnic groups and gender. 
Spotlight Support from Friends and Family Members
  • Help viewers better understand how to support people in their own lives, including turning to a trusted adult if needed. 
  • Friends are often the first people to notice that someone is self-injuring or hiding injuries, but it can be a difficult subject to bring up and the person who is self-injuring might not be receptive and could instead isolate more. Friends may have to go to a family member or another trusted adult and share their concerns. 
Depict Effective, Realistic Help-Seeking and Treatment
  • Depict the process of reaching out for and getting help to illustrate the importance of being proactive about this dangerous behavior. 
  • Given that people who self-injure are at increased risk for other mental health conditions and suicide, earlier intervention and treatment is important. 
Highlight the Power of Coping Skills and Self-Care 
  • Show alternative coping mechanisms.
  • People who self-injure may feel like it is their only and best coping mechanism since the act can give a temporary sense of relief. Seeing authentic portrayals of young people finding other, healthier ways to cope may open up those possibilities for viewers who also self-injure. 
Represent the Complex Causes of Mental Health Challenges
  • Depict the connection between trauma and self-injury. 
  • Self-injury is sometimes associated with childhood abuse or other traumatic events early in life. It is also frequently connected to conditions like eating disorders, anxiety, and depression. 
  • Depicting these causes and connections can help families and communities better identify and support people who may be self-injuring. 
Consider the Impact of Language
  • Avoid phrases that connect self-injury behaviors to someone’s identity, such as “he or she is a cutter.” 
  • Instead say that “he or she self-injures” so viewers struggling see these as behaviors that one can move on from. 
Avoid Sharing Potentially Harmful Details
  • Avoid showing the acts of cutting, burning or scratching, and scars or injuries related to these acts to limit the risk of contagion.
  • Seeing the act of self-injury can trigger similar impulses in viewers who are currently or have previously self-injured. 
  • Showing these acts may also inadvertently give people who self-injure ideas for new ways to inflict harm or hide injuries related to those behaviors. 

Snapshot

Self-injury, also called self-harm and non-suicidal self-injury, means deliberately self-inflicting immediate harm to the body without the intention of suicide. Self-injuring behaviors can include cutting, scratching, burning, punching, or embedding objects under the skin. Cutting is the most common (and most commonly depicted) behavior, but over 16 forms of self-injury have been identified to date. The harm can be inflicted anywhere on the body at varying degrees from superficial to lasting damage. 

Media tends to represent self-injury as a middle- to upper-class white female issue, but data shows similar rates of prevalence across race, ethnicity, gender, and socioeconomic status. An estimated 12% to 35% of high school students and 12% to 20% of young adults will self-injure. Most individuals who self-injure start the behavior between the ages of 10 to 24, and stop self-injuring within five years. 

The reasons behind self-injury differ from person to person, but generally represent an unhealthy coping mechanism. Common reasons given by those who self-injure include feeling numb, wanting to have control over their bodies, distraction, communicating pain, self-punishing, and reenacting trauma. 

Self-injury is often linked to other mental health conditions including eating disorders, substance misuse, post-traumatic stress disorder, borderline personality disorder, depression, and anxiety disorders. The most effective treatment is therapy and the development of healthier coping skills. 

Facts & Stats

The most common forms of self-injury (in order of prevalence) are cutting, head banging or hitting, and burning. 
Self-injury is most common among adolescents and young adults. Lifetime rates in these populations are about 15% to 20% and onset typically occurs around age 13 or 14. In contrast, about 6% of adults report a history of self-injury.
Recent research suggests that the increasing prevalence of self-injury on the internet and in popular media, such as movies, books, and news reports may play a role in the spread of self-injury.
Rates of self-injury are highest among people with mental health conditions like eating disorders, depression, anxiety and borderline personality disorder.
About 55% of people who self-injure also have eating disorders.
People who have engaged in 20 or more self-injury behaviors are about 3.5 times more likely to attempt suicide compared to those who have engaged in fewer self-injury actions.

Symptoms & Warning Signs

Risk Factors
  • Having friends or family members who self-injure
  • Experiencing stressful life situations like traumatic events, family instability, and sexual identity uncertainty
  • Living in social isolation
  • Mental health conditions, like depression, anxiety, and personality disorders
  • Eating disorders
  • Drug and alcohol use or misuse
Warning Signs
  • Unexplained frequent injuries, including cuts and burns
  • Low self-esteem
  • Difficulty handling feelings
  • Relationship problems or avoidance of relationships
  • Poor functioning at work, school, or home
  • Wearing long sleeves or long pants, even in hot weather

Treatment Options

  • Talk Therapy This approach can be used to help regulate and deal with difficult feelings, find healthier coping strategies, and treat any underlying mental health conditions like depression or anxiety.
  • Family Counseling or Support Groups These options can help in developing stronger relationships and interpersonal skills.
  • Medication Responsibly prescribed medication can be used to manage underlying mental health conditions like depression.

Need more guidance on depicting self-injury? Browse the expert directory >

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