How to Respond to Self-Harm

By Laura Greenstein | Mar. 01, 2018


Have you ever looked at someone and noticed a series of scars on their wrists? Did you make a face or pass judgement about that person without knowing who they are or what they’re going through? Likely.

Of the many symptoms of mental health conditions, self-harm is one of the least understood and least sympathized. It’s also one of the few physically visible symptoms. Therefore, it’s often responded to in a way that’s derogatory and potentially harmful. For example:

“That’s just teenage angst.”

“Why would anyone do that to themselves?”

“You’re just trying to get attention.”

These reactions grossly undermine how serious self-harm is. Self-harm is usually a sign that a person is struggling emotionally and isn’t sure how to cope. It’s a sign that a person needs support, understanding and professional help. Most importantly, it’s a sign that shouldn’t be ignored or judged.

Your Initial Response

It can be shocking to notice a person’s self-harm scars. Your instinct may be to stare or immediately express shock. But self-harm is a sensitive topic that should be approached in a certain way.

Whether you know the person or not, it is essential not to display shock or horror even if that’s how you feel. Don’t say anything that could shame them or make them feel judged or foolish. You don’t want to draw attention to their scars, especially in public.

If the person is a close friend or family member, don’t ignore what you’ve seen. Wait until you are with them in private, and then talk to them about what you noticed.

Having a Meaningful Conversation

The most important part of talking to someone about self-harm is to frame the conversation in a supportive and empathetic way. Show concern for their well-being and be persistent if they don’t open up right away. When having a conversation about self-harm, consider the following do’s and don’ts:


  • Show compassion
  • Respect what the person is telling you, even if you don’t understand it
  • Stay emotionally neutral
  • Listen, even if it makes you uncomfortable
  • Encourage them to use their voice, rather than their body as a means of self-expression
  • Encourage them to seek mental health care


  • Pity them
  • Joke about it
  • Guilt them about how their actions affect others
  • Give ultimatums
  • Remind them how it looks or what people will think
  • Make assumptions

Continuing Support

After that first conversation, it’s important to follow-up with your loved one to show your ongoing support. If they have not sought out care, continue to ask about it and offer to help them find a mental health professional.

You can also offer to help identify their self-harm triggers. You can do this by asking questions like: “What were you doing beforehand?” “Was there anything that upset you or stressed you out that day?” If a person is more aware of their triggers, it could help prevent future self-injury. Assisting your loved one find and practice healthier coping mechanisms is also a great way to help.

Self-harm is a serious issue that should be addressed as soon as you find out it’s happening. Keep in mind that one of the best things you can instill in a person who is self-harming is that you are there for them and that you care about them. You can always be helpful to someone even if you don’t understand what they’re going through.


Learn more about self-harm during NAMI’s Ask the Expert Webinar on Thursday, March 1.
Click here for more information on the webinar and to register!


Laura Greenstein is communications manager at NAMI.

Veronica Vale
This is a very good article. One thing not mentioned though is that self-harm is not a sign of suicidality.Also, very often it also indicates a major trauma in their past. thank you NAMI for informing people !
3/2/2018 3:43:09 PM

Karen crumm
Great page! Thank you for speaking out too help others!
3/2/2018 10:47:30 AM

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