Understanding Self-Harm in College Students

College students self-harm for many reasons. Learn about the causes and types of self-harm and the steps to take to stop self-injury.
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Note: If you or someone you know is considering suicide, please contact the 988 Suicide and Crisis Lifeline (dial 988), available 24 hours a day, seven days a week. All calls are confidential, and anyone can use this service.

  • A 2020 study found that around 25% of college students engage in self-harm.
  • Self-injury may be a response to stress or a way to cope with intense emotions.
  • Severe forms of self-harm put students at greater risk of suicide.
  • Developing healthy coping skills can help students end the cycle of self-injury.

Self-harm, also known as nonsuicidal self-injury (NSSI), is when someone purposely injures their body. Common forms of self-injury include cutting, burning, and scratching skin until it bleeds.

Typically, people self-harm as a coping mechanism to mitigate intense feelings, such as sadness, anger, or loss of control. In the fall 2020 Healthy Minds Study, 36 schools reported that 23% of college students inflicted harm upon themselves in the past year.

Self-harm is a dangerous condition that can impact students, children, and adults. In this guide, we look at the different signs and types of self-harm and go over strategies for stopping self-injury.

Why Do People Self-Harm?

While the causes of self-harm can vary, college stress may act as a trigger. Unexpressed intense emotions, feelings of powerlessness, and emotional numbness can all contribute to the desire to engage in self-injury.

Some may also perceive NSSI as punishment for something they think they did wrong.

People may turn to self-injury in an effort to manage their emotional distress or sense of disconnectedness. They might use self-harm to distract themselves from overwhelming emotions and to feel something physical when experiencing emotional detachment.

College students in particular may use NSSI to cope with depression, anxiety, and other mental health conditions. Symptoms of depression, such as feelings of worthlessness, irritability, and anger, can lead to urges to self-harm.

Additional risk factors include feelings of isolation and a history of chronic stress, trauma, or abuse. Substance misuse and disordered eating behaviors may also increase the risk of NSSI.

What Are the Different Types of Self-Harm?

Studies by Cornell University have identified over 16 forms of self-harm. The following represent some of the most common methods of self-injury. Note that most people use more than one method to engage in self-harm.

Cutting, Scratching, or Piercing Skin

According to Mental Health America (MHA), skin cutting is the most common form of self-harm, used by 70-90% of people who engage in NSSI. People may cut, severely scratch, or pierce their skin with a sharp object, often to the point of drawing blood.

Cutting may also involve carving symbols or words into the skin.

Punching or Hitting

Punching involves striking an object with a closed fist. For example, students may punch walls, objects, or even themselves. Other common forms of self-injury include hitting and head banging, which are used in 21-44% of self-injury cases, according to MHA.


This type of self-injury may involve burning one's skin with a lighter, cigarette, or heated knife. People may also brand their skin using hot objects. MHA reports that 15-35% of those who self-harm exhibit this behavior.

Common target areas for self-injury include the arms, hands, wrists, stomach, and thighs.

Hair Pulling

Students engaged in NSSI may at times use hair pulling to cause pain or distract from emotions. However, hair pulling is also a mental health condition in and of itself. Trichotillomania — or hair-pulling disorder — occurs with little awareness on the part of the person performing the act.

The act of pulling one's hair may reduce stress and usually involves recurring episodes despite attempts to stop.

Alcohol or Drug Misuse

Alcohol or drug misuse is another form of self-harm students may use to cope with intense feelings. While drinking alcohol or using drugs may provide short-term relief, these actions can result in long-lasting, unseen physical effects.

Using alcohol and drugs to self-medicate can also incite poor judgment and aggression and may lead to acts of self-harm that end up more severe than intended.

Thirty-three percent of respondents to two Cornell studies felt they had injured themselves to the point that they should have sought medical attention — but only 6.5% ever received treatment.

What Are the Signs of Self-Harm?

Because of the stigma associated with self-harm, many students do not seek help and try to hide their injuries. If you notice the following symptoms in a friend or peer, start a nonjudgmental conversation, explore positive coping strategies, and suggest counseling:

  • Scars
  • Fresh cuts on arms or legs
  • Scratches, burns, or bruising
  • Wearing pants and long-sleeve shirts, even on hot days
  • Feelings of worthlessness or helplessness
  • Increased social withdrawal or anxiety
  • Possession of cutting instruments, such as razor blades

Is There a Connection Between Self-Harm and Suicide?

People often turn to NSSI in an attempt to cope or feel better. That said, those who self-harm frequently or who use severe forms of self-injury are considered to be at greater risk of taking their own lives.

A May 2020 study published in "Frontiers in Psychology" found that those who have attempted suicide and those who self-harm share environmental risk factors, such as high levels of stress, unsupportive or uncaring families, a sense of isolation, and a history of trauma or abuse. These factors can increase a person's chances of transitioning from self-injury to suicidal ideation and intent.

In "Healing Self-Injury: A Compassionate Guide for Parents and Other Loved Ones," Janis Whitlock and Elizabeth Lloyd-Richardson write that about 65% of youths who self-injure will experience suicidal thoughts at some point. In contrast, only 36% of U.S. adults who self-harm reported feeling suicidal.

How to Stop Self-Harm: 5 Essential Tips for Students

Stopping and preventing self-harm involves replacing negative coping skills with positive ones. Managing intense feelings may also require the help of professionals, like counselors.

The following represent some of the essential actions students can take to stop self-harm and start healing.

1. Form a Strong Support Network

People engaged in self-harm often feel isolated and disconnected. Expanding social networks and developing a strong support group can help a student form needed connections.

Find school or outside support groups that help students realize their strengths, develop skills in areas like compassion and mindfulness, and provide tools for managing stress and everyday challenges.

2. Identify Ways to Manage Stress and Anxiety

Self-injury is often cyclical, occurring when a person feels increasing stress or negative feelings. Until they replace this coping strategy with healthier methods, and address underlying causes for this behavior, the self-harm will likely continue.

Alternatives for managing stress include practicing yoga or tai chi, aiming to keep a consistent sleep schedule, and performing mindfulness practices such as belly breathing, meditation, and visualization. When feeling overwhelmed, it can help to prioritize stressors, focus on one thing at a time, and reach out for support.

3. Try Healthy Alternatives to Self-Harm

Consider healthy options for relieving physical and emotional tension and stress. Regular exercise is a powerful antidote. During workouts, people release endorphins in the brain. These chemicals can reduce pain, trigger positive feelings, boost self-esteem, and ward off anxiety.

Additional alternatives include painting, journaling, listening to calming music, and talking with friends.

4. Consider Counseling

Most college campuses provide mental health services and treatment for students. Counselors can help students find alternatives to self-harm and provide needed emotional support.

One form of counseling, cognitive behavioral therapy, can help students understand their self-harm behavior and develop healthy coping strategies and problem-solving skills.

5. Get Help When You Need It

One of the most important things to know is that you don't need to go through this alone. Many hotlines and resources are available to support you or help during emergencies.

The Crisis Text Line offers 24/7 support. Text HOME to 741741 to get in touch with a volunteer crisis counselor. If you're experiencing thoughts of suicide, call the 988 Suicide and Crisis Lifeline (dial 988), available 24 hours a day, seven days a week. All calls are confidential, and anyone can use this service.

S.A.F.E. Alternatives also offers resources, information, and treatment options for self-harm.

How to Help Someone Who Self-Harms

If you believe someone may be engaging in self-harm, try not to judge or criticize them when you bring up the topic. Calmly demonstrating your concern can open the doors of communication and lead to opportunities for recovery.

Tell them many options are available and they should not attempt to handle this alone. You might suggest healthy coping mechanisms such as talking with a friend or seeing a counselor.

If they express any suicidal intent, such as feeling like a burden to others or wanting to die, seek help immediately. You can go to your college's counseling and psychological services as well.

Disclaimer: The information provided on this website is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment; instead, all information, content, and materials available on this site are for general informational purposes only. Readers of this website should consult with their physician to obtain advice with respect to any medical condition or treatment.