A new U.S. study suggests teens who self-harm need non-judgmental listening and minimizing harm rather than strict control and suicide watch.

Teens who deliberately harm themselves — usually by cutting or burning —are often dealing with stress, depression, or anxiety, and trying to relieve their emotional pain through physical pain.

“Recognize what deliberate self-harm is: A voice on the skin, a cry for help when they are either unable to voice their pain or when no one listens,” says Dr. Jacqueline Mangnall, a psychiatric nurse and Chairperson of the Department of Nursing at Jamestown College in North Dakota.

Dr. Mangnall and colleagues reviewed the medical literature on self-harm and also spoke to many people who had cut themselves, to find the best ways of dealing with self harm. The study was published in the July 2008 issue of the journal Perspectives in Psychiatric Care.

An earlier Canadian study revealed how common this practice is here:

Almost one in six teenagers deliberately harm themselves by cutting, burning or other self-harming behaviours, according to a report in the Canadian Medical Association Journal.

Girls are twice as likely as boys to self-harm. Teens who cut are not usually trying to commit suicide, but rather to find a release of their emotional pain; some have been abused in the past.

The practice is highly addictive and very difficult to treat once it takes hold.

Standard treatment for these kids is to place them in a highly restrictive environment or to place them on suicide precautions, says Dr. Mangnall. They often feel like they are being punished — rather than listened to — for their behaviour. “Most of the women that I talked to regarding their self-harm stated that no one had actually allowed them to talk about their self-harm behaviours,” she says.

Dr. Mangnall believes treatment programs that listen to kids, teach them other coping mechanisms, and minimize the harm they do to themselves may be more effective than completely forbidding any form of self-harm.

Her advice to friends and families of teenagers who cut themselves? “Recognize that deliberate self-harm is not the problem but a symptom of something deeper.”

For instance, if a teen cuts as a way of dealing with earlier abuse or neglect, it is the abuse or neglect — not just the cutting — that needs to be dealt with in therapy.

She adds, “even though it is a coping mechanism, it is a maladaptive one and we must find ways to help those who self-harm to find more adaptive ways of coping.”

Celia Milne, Metro, December 2, 2008