Self-Harm and Attempted Suicide Response

Definitions and myths about self-harm

Definitions

Maladaptive behaviours
Ways of dealing with distress that may provide some temporary or immediate relief but can have negative outcomes either in the short or long term. Maladaptive behaviours may also be referred to as dysfunctional behaviours.

Non-suicidal self-harm/non-suicidal self-injury
The act of a person deliberately hurting their body, and the absence of suicidal intent has been explicitly established.

Self-harm
The act of a person deliberately hurting their body, and where the intent to die is either absent or not able to be determined. Intent is the defining factor differentiating a suicide attempt from self-harm.

Social contagion
When other students are aware of and are influenced by their peer’s self-harm behaviours, either through directly witnessing the behaviour, seeing photos or wounds after the event or being encouraged to engage in the behaviour to increase sense of belonging or show empathy.

Suicidal behaviour
Refers to all non-fatal suicidal thoughts and behaviours, including suicidal ideation, suicide plan, and suicide attempt. This also includes suicide-related communications, both verbal and non-verbal, and expressing suicidal intent.

Suicidal ideation/suicidal thoughts
Thoughts about engaging in behaviour intended to end one’s life. This is defined as ‘active’ ideation, however, people can also experience ‘passive’ ideation, where there is a desire for death but not explicit thoughts of ending one’s life. Suicidal ideation/thoughts can also be historical (that is, a person has experienced them in the past) or current.

Suicide
The act of intentionally causing one’s own death.

Suicide attempt
An act carried out by an individual where the intended outcome is death, and they survive. Intent is the defining factor differentiating a suicide attempt from self-harm.

Vicarious trauma
Often used interchangeably with ‘secondary trauma’ and refers to the emotional and psychological stress that results from being exposed to the trauma of others.

Myths about self-harm

Myth: Self-harm is an act of ‘attention seeking’

Fact: Referring to self-harm as attention seeking assumes the student is in control of their behaviours, is making a conscious choice and is trying to be noticed. In fact, the opposite can be true. Students who engage in self-harm behaviours, particularly at the primary level, are often responding to distress they are experiencing and are struggling to articulate. This requires a non-judgemental, compassionate and supportive response that validates their experiences and fosters healing. Instead of viewing the behaviour as attention seeking, it is important to build the student’s positive coping skills.

This is particularly important for neurodivergent students, as self-harm behaviours are common for those with some neurodevelopmental disorders. While self-harm is not a symptom of these disorders, it can be a form of communication or a coping strategy in response to situations or environments that they find distressing, even though they may be non-suicidal in ideation.

Myth: All self-harm leads to suicidal thoughts or mental illness

Fact: People who have previously engaged in self-harm can be at increased risk of experiencing suicidal thoughts and behaviours. However, engaging in self-harm does not mean someone has, or will develop, a mental illness or suicidal thoughts.

Myth: Talking to children about self-harm or suicidal thoughts puts the idea in their head

Fact: Talking to a student about self-harm or suicidal thoughts does not give them ideas. It is important to have open conversations with students about their mental health and wellbeing because this can encourage them to talk about their experiences and encourage help seeking.

If a child or young person has been exposed to information about or images of self-harm, talking to them about it can support them to make sense of what they have seen.

When discussing self-harm or suicide it is important to use non-stigmatising language and not use language that glamorises self-harm or suicide.

Myth: Self-harm is always cutting

Fact: While cutting does make up a significant proportion of self-harm, particularly amongst adolescents, it is not the only way young people engage in self-harm. Other self-harm behaviours, particularly for primary-age students, include scratching, picking at wounds or scars, self-hitting, headbanging, pulling out hair, pinching, restricting food intake, poisoning and running across the road recklessly.

Myth: Primary school aged students are too young to self-harm

Fact: While self-harm reaches peak rates during adolescence, primary school aged children can engage in self-harm behaviours. There is evidence that rates of self-harm are increasing amongst this younger age cohort. Self-harm behaviours we see from children are likely to be expressions of distress because they are experiencing emotions that they are unable to manage on their own. The ways in which children express distress and types of self-harm may vary between different age cohorts.