Some names have been changed to protect privacy

Content warning: this story contains language pertaining to suicide and self-harm

Sophomore Jane’s phone pinged as she drifted off to sleep. She glanced at the notification in the dim light of her phone, her thumbs hovering over it for a moment. She clicked on a message she knew all too well, reading, “Hey, can you talk?”

One in four teenagers knows a friend who self-harms, and those who do are twice as likely to engage in self-harm themselves. 

Self-harm is becoming increasingly prevalent among adolescents — not just the behavior, but also the culture surrounding the act. Conversations about self-harm have evolved from silent struggles to open discussions in group chats, late-night phone calls and social media posts, sometimes blurring the line between healthy support among friends and emotional codependency. 

Teenagers who self-harm tend to confide in friends earlier, making them the first line of defense. The escalating exposure to self-harm through social channels can have lasting impacts, as in a study, adolescents who knew a friend who self-harms were nearly five times more likely to experience suicidal ideation and four times more likely to attempt suicide. Experts call this effect social contagion — the spread of behaviors and emotions. As peer support becomes more common, it raises questions about how teenagers navigate difficult situations and how schools and adults can respond to support youth. 

Teens often turn to friends rather than to adults when they need support. A 2023 survey found that over 70% of youth respondents said they’d confide in a friend about emotional challenges, while 40% would feel comfortable talking to a parent. In a 2024 Fitcy Health article, Therapist Gaston Molina said this often stems from teens viewing parents as authority figures rather than confidants. He noted that teens avoid opening up as they fear judgment and misunderstanding. 

For Sophomore Sarah, talking to someone with similar struggles concerning self-harm made coping easier.

“My boyfriend had experiences in seventh grade with self-harm,” Sarah said, “so he was very understanding.” 

Experts warn that leaning too heavily on unqualified peers, especially those who are also struggling, can create toxic support systems. Without guidance from adults or trained professionals, teenagers can end up trapped in cycles of shared distress, perceiving this as healing and normal comfort. In some instances, relying solely on peer support can actively exacerbate situations. When her repeated attempts to seek peer support failed, Sarah felt increasingly isolated and her thoughts of self-harm intensified. 

“Pretty much every time I’ve done it, I’ve texted my friends, ‘Hi, can you talk?’ And then nobody’s responded,” Sarah said. “It’s a little bit of that isolating feeling like no one’s there, feeling like you have no one — that no one would notice.”

Self-harm behaviors can heighten over time when individuals do not receive consistent support. In many cases, students are left managing these struggles without consistent professional support, instead often relying on peers who may not be adequately equipped to help. As teenage self-harm and suicide rates increase, the limitations of this informal peer support model grow more evident. Sarah said the lack of consistent support from peers sometimes led her to pressure her friends in hopes of receiving help more regularly. 

“In some weird way, [I thought] ‘maybe if somebody saw my scars, they would understand what I’m feeling,’” Sarah said.“It was a lot of unrealistic expectations of them.” 

Social determinants — non- medical factors that affect health outcomes  — can drive self-harm behavior. According to the National Library of Medicine, 21% of females and 10% of males initially self-harmed due to social factors. For many, the behavior began during periods of emotional distress. 

Many students feel that the schools’ methods of addressing self-harm do not fully address the complexity of self-harm dynamics, ultimately worsening outcomes. Jane said that the health curriculum fails to account for the nuances of different circumstances. 

 “Something that I don’t like about the self-harm curriculum, or how it’s taught, is that it’s very cookie-cutter,” Jane said. “[They say] If you see somebody self-harming, then report it,’ and I don’t think that’s a good solution in some cases.”

Maryland’s health curriculum standards require schools to teach students how to recognize signs of self-harming behaviors. The curriculum emphasizes alerting an adult if students are in danger of hurting themselves. As a public school, Whitman must follow both county and state standards. Whitman’s social worker Julian Smith says the school’s generalized approach is due to broader mandates. 

Beyond the curriculum, Whitman’s mental health support structure varies in visibility and effectiveness. Whitman offers resources such as the Bridge to Wellness program and Stressbusters. The Bridge to Wellness program includes access to therapy, whereas the Stressbusters program is a PTSA initiative to reduce stress through various events. However, Sarah, who has sought help for self-harm and provided support for others, said there was a disconnect between the available resources and the school’s implementation. She believes the school is not taking the necessary steps to effectively address students’ mental health needs. Smith said there has been a push to make the school support systems more reflective of student needs.

 “There’s an effort that we make within the school, the mental health providers, the administrators, counselors to create this nuanced messaging,” Smith said.

Structured peer support programs train young people with lived experiences to provide emotional and practical help to peers navigating mental health challenges, all under adult guidance. A 2024 report analyzed 70 studies and over 17,000 youth participants and found that structured interventions were significantly effective in more than 80% of cases. Unlike informal peer conversations, these programs included elements such as supervision and goal setting.

Smith proposed a similar program that blends peer support with adult oversight, one that would not directly focus on self-harm, but instead create a dedicated space for students to discuss their challenges. He emphasized the importance of reaching out to a trusted adult.

 Sarah, having been on both sides of the conversation, said that such situations can leave a lasting impact. 

“It’s remembering that it’s not that you are sharing their story,” Sarah said. “It affects you too.”