Supporting a Young Person Who Self-Harms

Finding out that a young person in your home has been hurting themselves is frightening, and the first instinct is almost always to do something big and immediate. The thing that helps is usually smaller and much quieter than that. This page covers what self-harm generally is, what to do in the first few minutes, and who to tell.

Please note: This is general information for foster carers, not medical advice about any individual young person. It follows NICE guideline NG225 and NHS guidance, and is correct as at September 2026. If someone’s life is at risk, or you cannot keep them safe, call 999 or go to A&E. For urgent advice at any hour, call 111 and select the mental health option.

What self-harm usually is

Self-harm is when someone deliberately hurts their own body as a way of handling feelings they cannot get out any other way. Our carers’ training calls it distress made physical, which is about right. A young person might be turning a feeling they cannot name into a pain they can point to, or wanting one thing in a life full of other people’s decisions that is theirs to decide. None of that is an attempt to end a life.

That distinction is real and it is only half the picture. NICE is blunt about the other half: people who have self-harmed are “at greatly increased risk of suicide”. Both things are true at the same time. A young person can be self-harming in order to keep going, and still be at more risk than a young person who isn’t. So the honest position is the awkward middle one. Don’t treat what you have found as a suicide attempt, and don’t treat it as a phase either.

The first few minutes matter more than the next few weeks

What you say when you first find out is what a young person weighs up before deciding whether to tell you anything again. The NHS list of what not to do is short, and nearly all of it is about control: “do not try to force them to change what they’re doing”, “do not threaten to take away their control”, “do not insult them, for example by saying they’re attention-seeking”. Anger is the common one, and it rarely looks like anger from the inside. It looks like urgency.

Don’t ask to see the injuries unless you think they need treating. A young person who has to roll up a sleeve on demand has learned that telling you costs something. What works instead sounds almost too dull to write down: you are glad they told you, you are not cross, and you will help them get to someone who knows about this properly. Then stop talking and let the silence sit there.

What you might notice

We are deliberately not printing a list of marks to look for, or of objects to hunt for in a bedroom. Lists like that turn carers into inspectors. What is worth noticing is change, and more than anything it is pace:

• a young person who always changed for PE and now will not
• long sleeves and a hoodie through a hot July week
• much longer behind a locked bathroom door than a month ago
• dropping the club or the friend they used to organise their week around
• a mood that has gone flat rather than loud

Any single one of those can just be being fifteen. It is the pattern, and the speed the pattern arrived at, that is worth a quiet word with your supervising social worker. You are not diagnosing anything. You are reporting a change, which is a complete report.

Who you tell, and when

Tell your supervising social worker, and do it the same day if you can. Tell the young person’s social worker too. Between them they will bring in the GP, who can refer on to children and young people’s mental health services, which most people still call CAMHS. Every young person in care has regular health reviews, so there is usually a route already open rather than one you have to build.

Write it down while it is fresh, in your foster carer records: what happened and what you did next. Record what happened, not what you think the young person is. A dated line that says “would not swim on Tuesday, said she was fine” is worth more to a clinician than a paragraph of your theory.

The plan is not yours to write

Some older guidance, including training material used in the sector, suggests a carer might discuss helping a young person to self-harm more safely at home, with a first aid kit and an agreed emergency plan. NICE NG225 states plainly that it “does not make any recommendations about the use of safer self-harm”, and where it does cover harm minimisation it puts that conversation with mental health professionals (recommendation 1.11.12). So do not design that plan at your kitchen table. Ask the clinical team for one, and ask for it in writing.

NICE does recommend a safety plan, built with the young person rather than for them (1.11.7). It names the triggers they recognise and who they will call. Your job is to know what is in it and to have the phone numbers somewhere better than the back of an envelope.

What helps in between

Most of what you can do day to day comes down to buying time and widening the exits:

• Delay. The urge usually peaks and then falls. Calm Harm, a free app in the UK funded by the teenage mental health charity stem4, is built on riding that out and is designed for over-13s.
• A box of their own. Photographs, a playlist, a letter from someone who loves them, the numbers below. Kept where they can reach it at eleven at night.
• Notes on what came before. Over a few weeks, patterns show up. Sunday evenings. After family time.
• Ordinary things, done often. A walk, baking something, a new skill, time with people who like them. The slow, unglamorous work of building emotional resilience is the part that lasts.

Underneath all of it sits the approach we train every carer in, therapeutic parenting and PACE: curiosity instead of interrogation, and acceptance of the feeling even when you are not accepting the behaviour.

Reducing what is to hand, with them rather than behind their back

Where the means of self-harm are to hand, NICE says to “discuss removing this with therapeutic collaboration or negotiation” (1.7.1). Collaboration is the operative word. It also suggests limiting the quantity of medicines kept for anyone with a history of self-harm, and returning what is not needed to a pharmacy (1.13.2). In practice that is a small thing: paracetamol in a kitchen cupboard rather than a bedside drawer, and smaller packs.

A secret search of a bedroom buys you one afternoon and costs you the conversation. Do the boring version instead, out loud, with them, and tell them why.

The phone is part of this

Some of what a struggling young person finds online makes things worse, and some of it is designed to. Set screen-time limits across the whole household so nobody feels singled out, and teach them to block and report the accounts that push this material at them. Filters buy time; disclosure keeps a young person safe, and our guide to online safety and a foster child has the rest.

Where to get help now

• 999 or A&E if someone’s life is at risk, or you cannot keep them safe. The NHS puts it well: “a mental health emergency should be taken as seriously as a physical one.”
• 111, then select the mental health option. Free, any hour, and you may be put through to a mental health professional.
• Childline, 0800 1111. Free, any hour, for anyone under 19.
• Samaritans, 116 123. Free, any hour, any age, and it does not show up on the phone bill.
• Shout. Text SHOUT to 85258, free, any hour, run by the charity Mental Health Innovations, for anyone struggling.
• YoungMinds Parents Helpline, 0808 802 5544. Free advice for parents and carers, foster carers named among them, about young people up to 25.

One number that used to appear on lists like this has gone. PAPYRUS Prevention of Young Suicide went into administration on 7 September 2026 and HOPELINE247 stopped operating. If you have 0800 068 4141 on a fridge magnet or in an old training pack, it no longer answers.

You won’t have to do this alone

Nobody at GLF thinks a young person self-harming in your home is a verdict on your care. Children arrive carrying things that started long before they met you. What we do is put experienced people around you: a supervising social worker who has sat in your kitchen and knows the young people in it, and an out-of-hours number that a real person answers. Our training goes well past the basics of supporting a young person’s mental health, and you will have other carers who have sat exactly where you are sitting.

The practical side is steady. GLF pays one weekly fee covering both allowance and reward: 479.50 pounds a week for a young person under 11 and 507.50 pounds a week from 11 upwards, per child, with an enhanced fee of roughly 100 to 200 pounds a week more where needs are higher. You can read the detail on our page about fostering pay, and about the support carers receive. Ofsted inspected us from 21 to 25 July 2025 and rated us Outstanding in all three judgements.

Frequently asked questions

Is self-harm the same as a suicide attempt?

Usually not. Most self-harm is a way of coping with distress rather than an attempt to end a life. But NICE is clear that people who have self-harmed are at greatly increased risk of suicide, so it is never something to wave away. Get clinical advice, without assuming the worst out loud in front of the young person.

A young person has asked me not to tell anyone. What do I do?

You cannot promise secrecy, and it is better to say that than to agree and break it later. What you can offer is honesty about the process: who you are telling and why. Tell your supervising social worker the same day. Being the person who told them the truth about what happens next is worth far more than being the person who kept a promise they should never have made.

Does this mean I have done something wrong?

No. Self-harm in a young person who has lived through loss and instability very often predates the home they are living in now. What you are judged on is whether you noticed, whether you told us, and whether you stayed warm while the right help was put in place. All three are things you can do.