We know Deliberate Self Harm (DSH) is common. One study talking to over 350 interested parties found about 1 in 15 children doing it from age 12 upwards. Other studies quote up to 1 in 7 in certain subgroups. So it matters. We know DSH invariably is nothing to do with suicide. We know that in younger folk (12 to early 20's) it's usually concealed (e.g. cutting arms then hiding the cuts under clothes) and is not about overt attention seeking.
Some groups seem at higher risk than others.
The National Institute of Health and Clinical Excellence has guidelines about this.
One key issue is that the self harm is a way for the young person to cope. They've often no better way to cope, which is why they cut. Stopping the cutting is stopping them coping. Thus, guidance is (sensibly) directed at looking at the causes of the DSH and addressing these rather than simply abolishing the self harm behaviour.
All well and good.
But, the crunch . . . just how do you explain to a terrified parent that we're going to accept their 19 year old teenager is still cutting themselves?
We'll offer alternatives (many distraction techniques work brilliantly) and CBT (which has established benefits after just a couple sessions) and medication (lorazepam can give similar relief that cutting does and works quickly to de-escalate distress) to try and reduce cutting and we'll give advice on cutting safely, but it's the loneliness and college pressure he's put himself under that needs sorting out then (invariably) the DSH diminishes and stops.
A difficult management plan to sell . . .