What Do You Do If a Foster Child Self-Harms?
You’ve noticed marks on her arms that weren’t there last week. Or he’s started wearing a hoodie in July and won’t say why. Your stomach drops. That moment is frightening, and it doesn’t mean you’ve failed or that you’re out of your depth. It means you need to know what to do next.
Please note: This page gives general information, not personalised medical advice for a specific child. If you are worried about a child’s safety, contact their GP, call 111, or call 999 in an emergency. This guidance reflects NHS advice current as of September 2026: read the NHS’s own advice on getting help for self-harm.
What Counts as Self-Harm?
Self-harm is when someone hurts their own body on purpose, usually as a way of coping with feelings that are too big to sit with any other way.
It can look like cutting, scratching, burning, hitting themselves, pulling out their own hair, or not eating enough. Some children hide it well. Others don’t hide it at all.
Self-harm and suicide are not the same thing. A child who self-harms is usually trying to get through a bad moment, not trying to end their life. But the two can overlap, and any sign of either needs a proper response, not a guess.
What Might You Notice?
There’s no single sign that proves anything on its own. But a few things, together, are worth paying attention to:
- Scars, scratches, cuts or bruises with no explanation
- Long sleeves or trousers even when it’s warm
- Not wanting to change for PE, or avoiding swimming
- Blood on clothing, bedding or tissues
- Scissors, tweezers or razors going missing, or turning up somewhere odd
- Locking the bathroom door for a long time
- Pulling away from you, from friends, from things they used to enjoy
A teenager who wears long sleeves in June might just run cold. But if two or three of these stack up, it’s worth a closer look, not a dismissal.
What Should You Do First?
Stay calm. That’s the whole instruction, and it’s the hardest part.
Don’t confront the child the moment you find out. Don’t show shock, and don’t show anger, even if what you’re feeling underneath is closer to fear than anger. A child who self-harms is already carrying more shame than you can probably see.
Don’t ask to see the injuries unless you’re worried they need medical attention right now. If you are worried, that’s different: get them seen.
Be the person they can talk to instead of the person they have to hide from. That takes patience. Let them come to it in their own time rather than pushing for the full story on day one.
Respect what they want to keep private. If they don’t want to show you an injury, and you’re not worried about their immediate medical safety, don’t push. If they don’t want to change in front of others for PE, back them up with the school rather than asking why.
If they do start talking, follow their pace. Don’t fill silences for them. Don’t rush to solve it before you’ve even heard it. PACE parenting, the approach many Fostering Hearts carers use day to day, was built for exactly this kind of moment: playfulness, acceptance, curiosity and empathy, rather than rules and consequences fired off before you understand what’s underneath.
You do not need to fix this today. You need to still be there tomorrow.
What Should You Avoid Doing?
- Forcing them to stop. It tends to push the behaviour further underground rather than end it.
- Punishing them for it, or taking away things they love as a consequence.
- Reacting with panic every time you spot a new mark. It teaches them to hide better, not to talk more.
- Watching them so closely they feel like a suspect in their own home.
A child who told a previous carer about something difficult and got shouted at, or ignored, or accused of attention-seeking, learns fast that the safest thing is silence. That’s the same lesson children learn when disclosing something difficult gets handled badly. Your job here is to be the exception to what they’ve learned to expect.
When Do You Bring in the Professionals?
Straight away, and quietly.
Tell your supervising social worker and the child’s social worker. This isn’t a betrayal of trust. It’s part of keeping the child safe, and it’s exactly what your foster carer records are for: dates, what you noticed, what was said. Patterns matter, and you won’t spot them from memory alone three weeks later.
Book a GP appointment. A GP can check for anything needing medical treatment and refer to CAMHS, the NHS’s Child and Adolescent Mental Health Services, for a proper assessment.
If you think the child is in immediate danger, call 111 for urgent advice or 999 in an emergency. Don’t wait for the next scheduled meeting.
There’s support for the child directly, too:
- Samaritans: 116 123, free, 24 hours
- Childline: 0800 1111, for anyone under 19
- YoungMinds Parents Helpline: 0808 802 5544
- Shout: text SHOUT to 85258
You will not be doing this on your own
This is exactly the kind of thing a supervising social worker exists for. At Fostering Hearts, supervising social workers support around six families each, not sixty, so when you call, you’re not queueing behind forty other cases.
One of our carers put it plainly in our last Ofsted inspection: “My supervising social worker has been an absolute lifeline for me. I feel so much more confident in my role because of her.”
Every child we place also carries a small card with contact details for someone they can call if something’s worrying them, so the responsibility for spotting trouble early doesn’t sit on your shoulders alone.
You’ll get training on this too, not just a leaflet and good luck. It builds on what you cover in Skills to Foster, and it keeps going long after your first panel meeting.
And your own wellbeing matters here too. Watching a child hurt themselves and holding it together for their sake is exhausting. Say that to your supervising social worker as well, not just the facts of what happened. You’re allowed to need support at the same time you’re giving it.
You don’t need to have this figured out before you apply.
Or read more about the support foster carers get.
Frequently asked questions
Is self-harm the same as attempting suicide?
No. Self-harm is usually a way of coping with distress, not an attempt to end life. The two aren’t the same, but they can overlap, so any sign of either deserves a proper response rather than an assumption either way.
Should I confront my foster child about it, or wait for them to bring it up?
Neither, exactly. Don’t ignore what you’ve noticed, but don’t ambush them either. Mention gently that you’ve noticed they seem to be struggling, and that you’re there when they’re ready to talk.
Do I have to tell the child’s social worker?
Yes. It needs recording and sharing with your supervising social worker and the child’s social worker straight away, so the right support gets put in place and everyone involved in the child’s care knows what’s happening.
Will I get training on this before it happens?
You’ll cover the basics in Skills to Foster, and Fostering Hearts runs further training on supporting children’s emotional wellbeing once you’re approved. Your supervising social worker is also there to talk it through whenever you need it, not just at review meetings.
What if I get it wrong the first time?
You probably will get something wrong. Most carers do, the first time. What matters more than getting it perfect is staying steady enough to try again the next day.
