The self-harm and the suicidal behaviors in adolescence they are a sign of suffering and one request for help that we cannot ignore. Behind a cut, a burn or impulsive behavior there is usually intense emotional pain and difficulties for regular either express what it feels like.
In this guide we explain what are they, how to detect them in time and what interventions work, with specific guidelines for educational centers, psychosocial services and mediation teams.
What we mean by self-harm and suicidal behavior
Self-harm (NSSI): deliberate damage to one's own body no intention of dying (e.g., cuts, burns, bruises). It usually works as emotional regulation, feeling of control or self-punishment.
Suicidal behavior: covers ideation, plans, attempts and completed suicide; exists intention (or clear risk) of dying.
Although they are different constructs, often coexist and share risk factors. Evaluate them jointly improves prevention.
Why we are seeing more cases
In the last decade, multiple surveillance systems and emergency services have observed more queries for self-harm and ideation/attempts in adolescents, especially girls, and in contexts with bullying, academic tension either family crisesThis has led to health and education to prioritize detection and response protocols.
Risk factors (multifactorial model)
Individuals: depression, eating disorders, impulsivity, low frustration tolerance, previous attempts.
Relatives: chronic conflict, violence, neglect, poor communication, family history of suicide or mental illness.
Social and school: bullying, exclusion, academic pressure, substance use, access to lethal means.
Cultural and media: contagion effect due to inadequate coverage, normalization of self-harm on networks.
Warning signs: what to look out for
Sudden changes in the mood (sadness, irritability), isolation, loss of interest.
Wounds or unexplained scarring, persistent use of long sleeves in heat.
Messages about empty, blame, farewells or “not make sense.”
Impulsiveness, substance use, academic decline and conflicts at home or in the classroom.
Keys to early detection
To train teachers, counselors, educators and mediators to ask questions directly and empathetically:
“When you feel overwhelmed, have you hurt yourself or thought about hurting yourself?”
Questions clear, without judgment and with time to listen make it easier for the teenager to open up.
Initial assessment and safety plan
If you notice any signs, immediately assess:
- Current risk (intention, plan, available means).
- Frequency and method from self-harm.
- Triggers recent (conflicts, losses, bullying).
- Support network (family, peers, adult role models).
Basic security plan
- Withdraw or limit access to media dangerous at home/center.
- Identify early signs and alternative strategies (breathing, behavioral distraction, contact with reference adult).
- List people and resources to which to turn.
- Set emergency steps (who to notify and how).
At risk high: activate emergencies either mental health; at risk moderate/low: preferential referral, close monitoring and interprofessional coordination.
Interventions that work
Cognitive behavioral therapy (CBT) adapted to suicidal/self-harming behavior: coping skills, problem-solving, cognitive restructuring.
Dialectical Behavior Therapy (DBT) for Adolescents: emotional regulation, tolerance to discomfort, interpersonal effectiveness and relapse prevention.
Working with the family: improve communication, reduce conflict, align guidelines and supervision.
School support: anti-bullying protocols, tutoring, access to counseling and safe spaces.
Pharmacotherapy: only for comorbidities (e.g., depression), never as the only approach.
The role of mediation with minors
mediation does not replace to therapy or clinical intervention, but Yeah can:
- De-escalate family and school conflicts that maintain the malaise.
- Structuring agreements coexistence (use of screens, schedules, study/leisure times).
- Ease safe dialogue between adolescent, family and educational center.
- Coordinate with mental health and social services, respecting confidentiality and its limits.
Good practices in mediation
Reviews periodic agreements and derivation if the risk increases.
Minimum protocol for educational centers and services
Operational checklist
Post-crisis plan (accompaniment, return to classrooms, follow-up).
Procedure of detection and derivation clear (who does what and when).
Training annual to faculty and teams (ask, contain, refer).
Security plan type (media withdrawal, key contacts).
Circuit of coordination with mental health/social services.
Communication criteria with families and protected registration.
Responsible communication and work with families
- Avoid minimize (“wants to attract attention”) and also dramatize.
- Replace “why are you doing it?” with “what were you feeling?” before to do it?
- Agree clear rules and predictable at home; reinforce self-care behaviors.
- In networks and internal media, do not describe methods nor show images of self-harm.
If there is imminent risk
Do not leave alone to the teenager.
Remove media accessible dangerous.
Contact with emergencies or the crisis resource local.
Inform the family/legal guardian and activate the clinical circuit.
Immediate help (Spain): Emergencies 112 · 24/7 Suicide Hotline 024.
If you are in another country, call the emergency services from your area or to a local helpline.
Frequent questions
Does asking about suicide “give you ideas”?
No. Ask in a direct and respectful manner is associated with reduction of risk and greater access to help.
What if the self-harm is “not serious”?
Any self-harm deserves evaluation. The “mild” can escalate, and always indicates discomfort.
Can mediation be carried out during a crisis?
The acute crisis is attended to first by mental healthMediation is useful after, to agree on support and routines.
Conclusion
It is not a “fashion”: it is real suffering. Detect soon, coordinate answers and accompany without judgment saves lives. Mediation with minors, integrated with health and education, reduces conflict, improves the communication and holds lasting changes.
Would you like to study these and other current topics related to childhood and adolescent development? Learn about the Postgraduate in Intervention with Minors and work on what you really like!
