Shame

Screening for self-harm and other negative mental health behaviors can save lives.

The National Institute of Mental Health Hospital published a study this week identifying emergency departments as a key setting for screening youth for suicide risk, mental health concerns and intentional self-harm.

The findings highlight the importance of screening children and adolescents in emergency settings. However, behaviors are not always severe enough to require hospitalization. In those cases, friends and family of a person with self-injurious behaviors should equip themselves with the tools to help.

The Centers for Disease Control and Prevention defines self-harm as anything a person does intentionally that can cause injury or death to self. March is Self-Harm Awareness Month, and Loma Linda University Behavioral Medicine Center’s Shield program is dedicated to working with adolescents struggling with self-harm and to address the tough questions surrounding the topic with families.

Non-suicidal self-injurious behavior can be prompted by a number of reasons, says Glenn Scott, LCSW, who works to destigmatize mental health issues in his position as director of the Youth Partial Hospital Program at Loma Linda University Behavioral Medicine Center. “Physical pain is sometimes easier to deal with than emotional pain,” Scott says. “When people choose to self-harm, it comes with a lot of shame — which makes individuals reluctant to seek help.”

A person who is trying to hide a behavior, such as cutting, may injure their stomach, thighs or other areas that make the behavior more difficult to detect. “You’re not going to see the physical evidence as easily, but you will see the emotional evidence,” Scott says.

People who have self-injurious behavior deal with emotional pain they feel they can’t control by creating physical pain that they can control, Scott says. “It’s like if you’re stressed out with a building project, and you hit your thumb with the hammer — you’re not stressed out about the stress anymore,” he says. “That physical pain takes over, and focus shifts.”

Warning signs that may indicate self-injurious behavior include:

  • Extreme emotions
  • Becoming closed off or unreachable
  • Expressing feelings of invalidation
  • Isolating (spending longer that needed in bathroom)
  • Missing or broken pencil sharpener or used razors in the trash
  • Feeling a lack of control or feeling they don’t have a voice
  • Wearing long-sleeves (especially in the summer)
  • Picking scabs or not allowing them to heal

If you do find that someone you know is harming themselves, it can make you feel helpless — desperate to help, but not always knowing how, Scott says. “It’s important to stay calm,” he says. “If a loved one talks to you about these behaviors, they’re placing their trust in you.”

Make sure you both go to a safe place, treat any serious injuries, and then just listen, Scott says.

If self-injurious behavior is causing suffering in your life, or the life of someone you care about, visit our behavioral health services website and learn more about how Loma Linda University Behavioral Medicine Center can help. Request information on a diagnosis or treatment, or any behavioral health concerns, and one of our intake coordinators will contact you.

If you or someone you know is in a life-threatening crisis now, seek help immediately. Call 1-800-273-TALK (8255) to reach a 24-hour crisis center or dial 911 for immediate assistance.