The Big Picture
Some people intentionally hurt themselves when they are struggling with difficult feelings. This is called self-harm. They may be trying to manage emotional pain, feel something when they feel numb, or regain control over their feelings.
Self-harm does not mean that someone necessarily has a mental illness. It also does not mean the person is trying to end their life. For some people, hurting themselves feels like a way to get through emotional distress.
As a Continuing Care Assistant (CCA), it is important to recognize possible warning signs and respond with kindness. A person who self-harms needs compassion and understanding, not judgment.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Self-harm means intentionally hurting oneself to manage difficult feelings or regain emotional control.
- Not everyone who self-harms has a mental illness.
- Self-harm may happen suddenly or be planned.
- Possible warning signs include unexplained injuries, multiple scars, and covering the body to hide injuries.
- Support clients with compassion, patience, and a nonjudgmental attitude.
- Encourage proper wound care, healthy coping methods, open communication, and professional help.
Jump to:
Course Notes: Key Ideas You Need to Know
What Is Self-Harm?
Self-harm means intentionally causing pain or injury to oneself to cope with difficult feelings.
These feelings may include:
- Anxiety: A vague, uneasy feeling in response to stress.
- Depression.
- Emotional numbness.
- Feeling a loss of control.
- Anger directed toward oneself.
A person may also self-harm to regain a sense of emotional control.
Key fact: Self-harm, as described here, is not intended to end the person’s life. Instead, the person may feel that hurting themselves is the best way they know to survive emotional distress.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition describes self-harm as injury without the intention to die.
Nova Scotia’s 811 health guidance explains that cutting usually does not indicate suicidal thoughts, although rare cases can involve them. It also warns that cutting can accidentally cause a severe or potentially fatal injury. Serious thoughts of suicide require emergency care.
Why this matters in Nova Scotia: Do not assume that someone is safe simply because their self-harm does not appear to be a suicide attempt. Serious injuries and concerns about suicide must be taken seriously.
Official source: Self-Harm — Cutting, Nova Scotia 811
Last checked: October 9, 2026
Why Do Some People Self-Harm?
Self-harm may provide temporary relief from difficult physical or emotional feelings.
One possible reason involves the release of chemicals in the body.
These chemicals include:
- Adrenaline.
- Dopamine.
- Endorphins.
Adrenaline, dopamine, and endorphins are examples of neurochemicals in the body.
Self-harm may trigger the release of these chemicals, which may reduce physical and emotional distress at that time.
This helps explain why some people turn to self-harm when they are struggling with painful emotions.
Self-Harm May Be Impulsive or Planned
Self-harm does not always happen in the same way.
- Impulsive self-harm: The person acts suddenly without planning the behaviour beforehand.
- Planned self-harm: The person thinks about and plans the behaviour before acting.
Difference: Some people self-harm on impulse, while others plan to hurt themselves.
Who Is More Likely to Self-Harm?
Self-harm can affect people in different circumstances. Certain experiences and difficulties are associated with a greater likelihood of self-harm.
Teenagers
Teenagers have higher reported rates of self-harm than the general population.
Number to remember:
- General population: Self-harm affects 1% to 4% of people.
- Teenagers: Reported rates range from 14% to 39%.
Possible reasons for the higher rates among teenagers include:
- Experiencing intense emotions.
- Having conflicts with adults.
- Feeling lonely.
- Dealing with pressure from peers .
These are possible contributing factors, not definite explanations for every teenager who self-harms.
People Experiencing Emotional Difficulties
People may be more likely to self-harm when they:
- Want to numb emotional pain.
- Feel badly about themselves or have low self-esteem.
- Have difficulty expressing their feelings.
- Struggle to cope with negative events or emotions.
- Are dealing with abuse they may have experienced.
Some people say they do not feel physical pain when they hurt themselves. Others self-harm because they want to feel physical pain.
Key fact: People may self-harm for different emotional reasons, even when their actions look similar.
People Living With Mental Health Disorders
Self-harm is more common among people who live with certain mental health disorders.
A mental health disorder, also called a mental illness, affects a person’s ability to cope with or adjust to stress. It can affect thinking, mood, or behaviour and interfere with the person’s ability to function.
Mental health disorders associated with higher rates of self-harm include:
- Eating disorders.
- Depression.
- Anxiety disorders.
- Substance use disorders.
- Some personality disorders.
Important difference: A mental health disorder may increase the likelihood of self-harm, but not everyone who self-harms lives with a mental illness.
Common Ways People Self-Harm
Self-harm can involve different actions that cause physical injury.
Common methods include:
- Cutting the skin.
- Burning the skin.
- Scratching until the skin breaks.
- Hitting oneself hard enough to cause bruises or broken bones.
- Biting oneself.
- Falling.
Some people also harm themselves by taking a minor overdose of a substance.
For example, a person may take more than the recommended dose of an OTC medication, but not a lethal dose.
The important distinction is that the person takes more than the recommended amount to harm themselves, rather than to end their life.
Warning Signs of Self-Harm
Self-harm can be difficult to recognize.
Some people try to hide their injuries because they feel embarrassed or ashamed. Others may worry about being punished.
Possible warning signs include:
- Unexplained wounds: Cuts, burns, or bruises without a clear explanation.
- Multiple unexplained scars: Several scars that the person cannot explain.
- Frequent accident explanations: The person repeatedly says they are accident-prone or have many accidents.
- Covering the body: The person regularly wears clothing that covers their body, even in warm weather.
These are possible warning signs. They do not automatically establish that a person is self-harming.
Key fact: A person may intentionally conceal signs of self-harm, so injuries may not always be easy to notice.
How to Support a Client Who Self-Harms
A client who self-harms is in distress. Respond with compassion and without judgment at all times.
- Wound care: Encourage proper treatment of wounds to avoid infection.
- Personal concerns: Focus on the person’s concerns or issues rather than the act of self-harm.
- Healthy coping: Encourage positive, healthy coping methods. Learning skills that replace harmful coping methods takes time.
- Communication: Encourage open communication and be willing to listen, without forcing the person to talk.
- Professional help: Encourage the person to seek professional help for self-harming behaviours.
- Support for others: Encourage friends and significant others to seek support from a mental health professional or support group.
Nova Scotia CCA Note
Sorrentino explains how to support someone who self-harms with compassion, listening, and encouragement.
In Nova Scotia, the current Continuing Care Assistant Occupational Standards of Practice also explain the CCA’s responsibilities. A CCA observes changes in a client’s behaviour, emotions, and physical condition. The CCA reports or brings concerns to a supervisor according to the care plan and workplace procedures.
A CCA may make observations while providing care, but these are not the same as a nursing assessment . Regulated health care professionals are responsible for broader assessments and care-planning decisions. CCAs follow planned care approaches rather than independently deciding on treatment.
Why this matters in Nova Scotia: If you notice possible self-harm injuries or concerning changes in a client’s behaviour, follow the appropriate reporting process. Do not attempt to diagnose the person or choose treatment yourself.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 9, 2026
Exam Clue Words
Pay attention to these words when reviewing how to support someone who self-harms.
- At all times: Compassion and a nonjudgmental attitude should remain part of the person’s support throughout.
- Avoid: Focusing on the act of self-harm instead of the person’s concerns or issues.
- Without forcing: Encourage open communication and be willing to listen, but do not make the person talk.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| Everyone who self-harms has a mental illness. | Not everyone who self-harms lives with a mental illness. |
| Self-harm always happens without planning. | Self-harm may be impulsive or planned. |
| Self-harm always involves feeling physical pain. | Some people report feeling no physical pain, while others want to feel physical pain. |
| A person who self-harms will always have visible injuries. | Some people deliberately cover or hide their injuries. |
| Focus only on the act of self-harm. | Focus on the person’s concerns or issues instead. |
| Encouraging communication means making the person explain their behaviour. | Be willing to listen without forcing the person to talk. |
Fast Review
Use these points for a quick review of self-harm, warning signs, and appropriate client support.
- Self-harm means intentionally hurting oneself to manage difficult feelings or regain emotional control.
- Self-harm, as described here, is not intended to end the person’s life.
- Not everyone who self-harms has a mental illness.
- Self-harm may happen impulsively or after planning.
- Self-harm affects 1% to 4% of the general population, compared with reported rates of 14% to 39% among teenagers.
- Common methods include cutting, burning, scratching, hitting, biting, falling, and taking a minor overdose of a substance.
- Warning signs include unexplained injuries, multiple scars, repeated accident explanations, and covering the body in warm weather.
- A person may hide injuries because of embarrassment, shame, or fear of punishment.
- Always respond with compassion and without judgment.
- Encourage proper treatment of wounds to avoid infection.
- Encourage positive coping methods and remember that learning them takes time.
- Encourage open communication without forcing the person to talk, and encourage professional help. Friends and significant others can also seek support.
Final Pep Talk
Self-harm can be an emotional topic to study, especially when you are learning to recognize warning signs and understand why people may hurt themselves. Focus on the differences between the behaviour, its possible causes, and the supportive response. You can review these ideas one section at a time until they become more familiar.