Academic pressure. Body image issues. Social relationships.
These are just some of the emotional challenges our adolescents and teens are facing today – with many turning to self-harm, or in extreme cases, suicidal thoughts, as a means of coping with their pain. According to the recent National Health and Morbidity Survey 2022 (Adolescent Health Survey 2022), 1 in 8 Malaysian adolescents (aged 13 to 17) have experienced suicidal thoughts, while 1 in 10 have attempted suicide.
The survey findings also revealed a worrying uptick in the prevalence of suicidal thoughts, from 10% in 2017, to 13.1% in 2022. Similarly, the rate of suicide attempts has risen, from 6.9% in 2017, to 9.5% in 2022.
According to psychotherapist Mr Khairul Arif bin Razali, there is no single clear cause of self-harm or suicidal thoughts amongst kids in today’s world. “However, young people who self-harm often feel overwhelming emotional pain,” he shares.
Others say they feel lonely, worthless or empty inside and will do anything to feel better, if only for a moment. Still others report feeling overstimulated, misunderstood or fearful of close relationships. Some feel overwhelmed by school and family responsibilities, or want to punish themselves for something bad they believe they’ve done. Self-harm can also be a way for kids to take control of their bodies when they feel a lack of control over other things—or when other aspects of their lives seem unmanageable.”
Other causes might include:
- A sudden life change like a death, divorce or moving school
- Exam stress, feelings of extreme pressure or fear of failure
- Witnessing or experiencing abuse at school, home, or in a relationship
- Witnessing or experiencing a severely distressing or traumatic incident
- Loneliness, feelings of guilt or being unloved
- Low self-esteem or issues with body image
- Criticism from family, friends or teachers
- Violence among peers
When a few of these issues come together, Mr Khairul adds that “they can quickly feel overwhelming and become too much for one person to deal with. Instead of finding ways to express those feelings to the world, some children start to take this pain and anger out on themselves”.
What is self-harm?
Self-harm is when individuals hurt themselves intentionally as a way of self-coping, managing their emotional pain, releasing stress or distracting themselves from memories of traumatic experiences. In severe cases, self-harm can be a prelude to suicidal thoughts or actions. It is vital for parents to recognise the warning signs of self-harm or suicide.
Signs may vary; however, parents should be aware of the more common indicators, such as:
1. Behavioural change
Has your child gone from being a chatty and cheerful person, to a quieter, more reserved one instead? Your children could be less inclined to participate in social interactions, and they might withdraw from taking part in activities that they once enjoyed. They might also prefer to isolate themselves from family and friends and spend excessive time on their own. Their sleeping patterns might be affected as well – some might experience insomnia, whilst others might sleep all day long.
2. Changes in your child’s appearance
There might be a drastic change in their eating habits as well. Your child could either be eating more than usual, or less; which would affect their weight. In terms of dressing up (or down), some might opt for a more sombre appearance, while others might prefer a more unconventional look. Still others might neglect dressing properly, or even worse, disregard their personal hygiene.
3. Emotional instability
Although it is common for teenagers to experience mood swings at their age, parents should keep a look out for more frequent signs of anger, or sudden outbursts amongst their children. Affected children might portray excessiveness of emotions and feelings; for example, feeling persistently sad or hopeless.
4. Different ways of coping
Parents should also look out for any signs of self-harm, such as bruises or cuts on their children’s wrists. Their children might also start using alcohol or drugs as ways of coping with their stress or emotional instability.
5. Making glaring statements
Some children tend to express their feelings openly, such as complaining that they are a burden to their families, and that all they should do is just die. Others might choose to express these thoughts through their writing, such as poems or diary entries, or through drawings and sketches. Each statement should not be taken lightly as just ‘attention seeking; rather, parents should give this the due attention it deserves, in excess of caution.
I’m a concerned parent. What can I do?
According to Mr Khairul, these are some key steps that parents can take to ensure immediate assistance is given, especially for urgent cases:
1. Have the conversation
Don’t be afraid to ask kids if they’re engaging in non-suicidal self-injury (NSSI) or self-harm, or if they know of others who are. Take a non-judgmental position, listening more than you speak. It’s alright to admit that the subject is tough for you, but express your love and concern. Try saying: “This is hard for me to even think about because I care about you and want you to be healthy and safe, always.”
2. Be prepared for strong reactions
Because people who practice NSSI often deny it (and try to hide the evidence), your child might be upset or refuse to talk. In a calmer moment, tell your child that you’re worried they might be self-harming, and that you plan to speak with their doctor about it. Encourage them to be there for this conversation, but even if they won’t go with you, make the appointment.
3. Make your home environment safer
If your child is self-harming, you can help by removing hazards, such as sharp knives, razors, poisons, weapons and more from your space. Though it can be difficult to remove all items all the time, it is especially important if your child lets you know they are having thoughts or urges to self-harm, or if they’re undergoing difficult, stressful periods that could trigger these thoughts or urges. It is also important to keep firearms inaccessible and all medications locked away, especially if your child is having suicidal thoughts.
4. Change the way you think about social media
While digital channels may not be a direct cause of NSSI, excessive screen time can lead to poor sleep and exaggerated feelings of envy, isolation, fear and self-rejection. These issues may feed the powerful emotions that prompt some kids to self-injure, so it’s worth the time to establish a healthy family media plan.
5. Prioritise family mental health and relationships
If your family faces consistently high levels of stress, take time to consider how you can turn this around. Young people need to know they can ask for downtime without guilt, and that self-care is a priority above mountains of schoolwork and extracurricular activities.
Are there resources I can turn to for help?
If you are concerned about your children’s mental health, do not hesitate to contact the right people to assist your family. Remember that reaching out for help does not indicate failure on your part; instead, it shows that you care for your children and want to provide the best support and specialised guidance available for them.
There are several resources in Malaysia that parents can turn to if they need to get more awareness or support; for example:
- Befrienders Malaysia;
- Talian Kasih 15999;
- The Mind Faculty;
- The Malaysian Mental Health Association (MMHA);
- KPJ Healthcare Berhad;
- Counselling services offered by private and public universities. These organisations can also assist parents, should they feel the need to reach out to mental health experts; and
- Other suicide helplines.
Do also refer to our earlier article for a list of mental health support resources you might wish to connect to.
I have younger kids, but I want to prioritise their mental health from an early age. What can I do?
1. Connect and communicate
Start by creating a comfortable environment, where your children feel secure in your love and are able to connect and communicate with you, when they need to. Don’t be afraid of engaging with them in conversations about mental health issues. Normalising sensitive conversations will encourage them to come to you, should they have any concerns in the future.
2. Maintain a healthy lifestyle
Physical health and mental health are inextricably connected. Encourage your children to stay physically fit by having regular exercise and physical activities outside the home, and by ensuring they have balanced nutrition in their daily food intake. It would also be great for you to join in some of their activities, such as cycling, hiking, or just strolling in the park.
3. Never stop learning
There is a wide array of resources about mental health; educating yourselves with the knowledge, and keeping up with the latest insights and trends will assist you in understanding the underlying causes and warning signs of self-harm and suicide – so you can approach these issues with empathy and knowledge.
4. Be observant
Pay attention to every detail and possible changes in your child’s moods, behaviour, appearance, and routines. The warning signs mentioned earlier in this article might indicate that your child could be struggling with a deeper underlying issue.
We know this isn’t always an easy journey, #makchicmumsquad – but remember that the story doesn’t end here for your kids, or for you. Your support can make a profound difference in helping them navigate the challenging moments in their lives.
By Nori Shamsuddin
[*The contents of this interview have been edited for brevity and clarity.]
Nori is a mother, a self-proclaimed poet, a hopeless romantic, and a freelance writer. Travelling excites, inspires and rejuvenates her and she shares her stories via her Travelling Bantal Busuk Series.
