By Ginny Gohr
Director, Boys Town National Hotline

Over the past few years, we have noticed a steady increase in the number of callers with self-injury behaviors. In 2002, we received 294 calls from persons whose primary issue was self-injury.  In 2007, that number more than doubled to 696, an average of almost two calls a day for an entire year.

The Hotline also handles hundreds of calls each year from people who are in crisis over relationships or mental health issues, and for whom self-injury is the secondary focus.

Regardless of whether self-injury is a primary or secondary reason for calling, a large number of these callers are children and teens. Consider these Hotline statistics:

• 42 percent of self-injury callers are under 18
• 21 percent of self-injury callers are between 19 and 23
• 87 percent of self-injury callers are female
• Females who are 18 or younger make up 37 percent of all self-injury callers

Parents need to understand that self-injury is not necessarily a suicide attempt.  Typically, people  intentionally injure themselves as a way to cope with other crises in their lives.  Kids and teens need to find better ways to deal with these situations.  One way is to call our Hotline because someone there is always ready to help.

How do Hotline counselors comfort self-injury callers and help them cope?

• They praise callers for taking the first step and talking about their issue (self-injury and cutting). Many times, these callers are in the midst of a crisis, which is when they typically will cause self-injury.
• They de-escalate the immediate crisis.  Counselors  work with the caller to help him or her identify alternative coping skills, which can include doing some deep breathing with the caller, having the caller write down his or her feelings in a journal, or having the caller engage in physical activity.  The main focus is to determine what works best for the caller.
• They assess any current safety issues:  Has the caller already self-injured? Does he or she need  medical attention?

Once counselors have comforted self-injury callers, what strategies do they offer?

• They help callers identify an emotional support system they have in place.  This involves having at least two people (friends, family members, a therapist, Hotline counselors) the person can call and talk to before self-injuring.
• They have callers create a list of at least 10 things they can do instead of self-injury.
• They ask callers to get rid of all the things they might use to harm themselves (razors, knives, lighters, etc.).
• They help callers understand that it is okay to feel uncomfortable, scared, and frustrated.
• They help callers understand that they can endure the thought of wanting to injure themselves without actually doing it.
• They encourage callers to express their feelings in writing (poetry, journaling, etc.).

We also encourage self-injurers to call us back if they feel like they are going to hurt themselves. We stress to them the importance of calling us or someone in their support system before they self-injure.

If you need help with self-injury and cutting, or know someone who does, call the Boys Town National Hotline toll free at 1.800.448.3000.  We also offer referrals to local programs that help people with self-injury issues and can provide information on treatment options.

To find out more about cutting, read the article, Understanding Teen Cutting and Self-Injury, (links to new article) an excellent resource that explains self-injurious behavior, risk factors, signs, and what to do.

If you are the parent of a child who self-injures, another resource is the book, When Your Child Is Cutting, by Merry E. McVey-Noble, and available from the Boys Town Press.