How to Talk With Your Teen About Self-Harm

The most helpful way to talk with your teen about self-harm is to stay calm, tell them plainly what you've noticed and that you love them, and then listen much more than you talk. Most parents are frightened going into this conversation, and many worry that asking will make things worse, but the American Academy of Pediatrics (AAP) tells parents directly, "Don't be afraid to ask kids if they're engaging in NSSI," meaning non-suicidal self-injury (AAP, 2024). The goal of a first conversation is to keep the door open, and you can work out the rest together, with help.

If you're worried about your teen's safety right now, call or text 988 (Suicide & Crisis Lifeline), or call 911 if your teen is in immediate danger. Our crisis page explains what happens when you call.

How do you start a conversation about self-harm?

A good way to start is privately, at a calm moment, with a short and honest statement of what you've noticed and why you're bringing it up. You might say, "I noticed something that worried me, and I love you too much not to ask about it," or "I've been worried about you, and I want to understand what's been going on." Starting with your care, rather than with evidence or a demand for an explanation, helps your teen hear that you're coming to them as an ally.

Timing matters as much as the words. A quiet drive, a walk, or sitting side by side tends to feel less intense to a teen than a face-to-face talk at the kitchen table, and late at night after a fight is usually the hardest moment to begin. If you've already found out and the first conversation happened in a rush, our guide on what to do if you find out your teen is self-harming covers the first hours and days, including when an injury needs medical care.

What should you say, and what should you avoid?

The most helpful things to say are short, warm, and honest, and the most harmful ones tend to carry shock, blame, or a demand. The AAP advises parents to "take a non-judgmental position, listening more than you speak" (AAP, 2024). The table below compares phrases that tend to open a conversation with ones that tend to close it down.

You won't say everything perfectly, and you don't need to. If something comes out wrong, you can come back later and say, "I didn't handle that well the other night, and I want to try again," which shows your teen that hard conversations can be repaired. Our guide on what not to say to a depressed teen covers many of the same pitfalls.

Why does listening matter more than fixing?

Listening matters more than fixing because a teen who self-harms is usually trying to manage feelings they can't put into words yet, and feeling heard is what makes it possible to say more. Self-harm is most often a way of coping with overwhelming emotional pain, and the AAP notes that it "may offer a momentary escape from the struggles a child can't seem to handle any other way" (AAP, 2024). Our guide on why some teens self-harm explains more about what may sit underneath it.

In practice, listening means asking one open question and then waiting, even through a long silence. It means reflecting back what you heard ("So school has felt like too much since the fall") rather than jumping to solutions, and it means not asking for details about the self-harm itself, which tends to deepen shame without helping you understand your teen's feelings. If your teen only says a little, that still counts. The same skills apply with a quiet teen generally, and our guide on talking to a withdrawn teen has more on drawing out a teen who doesn't want to talk.

Why shouldn't you ask your teen to promise to stop?

Asking your teen to promise to stop self-harming usually backfires, because the promise takes away a way of coping without putting anything in its place. A teen who makes that promise and then struggles may feel they've failed you on top of everything else, and that shame can make them less likely to tell you the next time things get hard.

A more helpful ask is for honesty and connection, like agreeing that they'll come to you or another trusted adult when feelings start to build. Recovery is usually gradual, and the AAP notes that most young people who repeatedly self-harm stop after their teenage years (AAP, 2024). A therapist can help your teen build other ways to cope with the feelings underneath, and that work, rather than a promise, is what helps self-harm become less necessary over time.

What if your teen denies it or gets angry?

If your teen denies it or gets angry, stay calm, keep the door open, and still move forward with getting help. The AAP tells parents to "be prepared for strong reactions," and suggests telling your child that you're worried they might be self-harming and that you plan to talk with their doctor about it (AAP, 2024).

You don't need a confession before you call the pediatrician. Saying something like "I hear you, and I'm still worried, so I'm going to call your doctor, and I'd like you to come with me" lets your teen keep some dignity while you act on your concern. Anger in that moment is often fear or embarrassment, and it usually softens once your teen sees that you aren't going to punish them or pull away.

How do you bring a professional into the conversation?

Bringing in a professional tends to go most smoothly when you do it openly, with your teen knowing what's happening and having some say in how it happens. The American Academy of Child and Adolescent Psychiatry (AACAP) notes that "evaluation by a mental health professional may assist in identifying and treating the underlying causes of self-injury" (AACAP, 2019), and the AAP recommends working with a clinician on a safety plan that covers home and how to get emergency care in a crisis (AAP, 2024).

Your teen's pediatrician is often the easiest first step, since your teen already knows them and they can refer you to a therapist who works with teens. Where you can, give your teen choices, like whether they'd prefer a male or female therapist, or whether you sit in for part of the first visit. If your teen refuses to go, our guide on whether you can make your teen go to treatment walks through your options, and many of the same ideas in our guide on talking to an anxious teen apply when a teen is scared of seeing someone new.

When should you get help?

You should involve a professional any time you learn your teen is self-harming, and some situations call for help right away. Talking with your teen is an important part of helping, but only a licensed professional can evaluate your teen and recommend the right care.

• Call 911 now if your teen is in immediate danger or has an injury that looks serious.
• Call or text 988 (Suicide & Crisis Lifeline) right away if your teen says they want to die or you're worried about their safety. Self-harm and suicidal thoughts are different, but they can overlap. The 988 Lifeline is free, confidential, and available 24/7, and it supports people who are worried about a loved one (988 Lifeline, 2026). Teens and parents can also text HOME to 741741 to reach Crisis Text Line, which is free and available 24/7 in the U.S. (Crisis Text Line, 2026). Our crisis page explains what happens when you reach out.
• Call your teen's pediatrician or a therapist this week if your teen is safe right now, whether or not they've admitted to self-harm and whether or not they want to go.

Most adolescents start with outpatient therapy, and our guide to levels of care explains the options if more support is recommended. More guides like this one are collected in our self-harm guide for parents.

This article shares practical guidance for parents and is not medical advice. We're not clinicians or doctors. If your teen is struggling, contact a licensed mental health professional or your teen's doctor, and if you have a serious concern about their safety, call 911 or call or text 988. Editorial standards