More young people are self-harming, say children's charities
Children's charities are warning that more young people are self-harming and that younger children are being affected.
Children as young as 10 are calling helplines to say they have hurt themselves in this way.
An estimated one in 12 young people in the UK are believed to have self-harmed at some point in their lives, experts say.
The charities have joined up to raise awareness of the issue.
They say they want to expose myths about self-harming and reduce the stigma attached to it so that more young people seek help.
Singer and X Factor judge Tulisa, who has talked in the past about how she harmed herself, is supporting the campaign.
ChildLine, YouthNet, YoungMinds and the website Selfharm.co.uk have come together to highlight the issue on Self-harm Awareness Day on Friday.
ChildLine says it has seen a dramatic - 167% - increase in people getting in touch about the problem over two years.
And it says it has become one of the top five concerns reported among 13-year-olds last year, whereas previously it was seen as a big issue for older teenagers.
The charity says children as young as 10 are contacting it over the problem.
In the year to March there were more than 600 counselling sessions - calls and messages - between ChildLine and children aged 10 to 12 where the main concern was self-harm.
That was out of a total of more than 16,000 sessions on the subject among children and teenagers of all ages.
The most common form of self-harm involves cutting the arms or legs with a razor or knife. But experts say it can include burning, biting, hitting, hair pulling and taking overdoses.
They say the most widely accepted definition is "a wide range of things that people do to themselves in a deliberate and usually hidden way, which are damaging".
Paediatrician and TV presenter Dr Ranj Singh says there are many theories about why young people do this: "The problem is related to emotional distress and anguish and feelings of anxiety, pain and depression.
"A lot of that can be due to increasing societal pressure as a whole," he told the BBC News website.
He said it was related to bullying, problems in the home including family relationships, abuse, alcohol and sexuality - a young person's developing sexuality and "society's reaction to that".
"Self-harm is the only way they feel they can cope [with what's going on]," he said.
"A lot of people think self-harm is rare but it's not; it's quite common and it's very complex. It's become a taboo subject and there is a hidden group that are really hurting.
"In my professional role I see evidence of young people self-harming far too much and yet I only see the tip of the iceberg."
'It all blew up'
Bethany, 19, said she began to hurt herself soon after her 17th birthday.
"A lot of stuff had been going on since I was 14 or 15. I had been stressed over a variety of things and it had all been building up," she said.
"I was doing my A-levels and it all blew up and I had no-one to talk to and I was desperate.
She says she began by scratching her arms and that there was a "slow descent" in to using sharp objects - "anything I could get my hands on".
"It was about control for me and about feeling something else apart from the hell I was feeling. I was not trying to kill myself."
Bethany said she came to see that she needed help because she realised the problem could go on for ever "or get even worse".
She went to see her GP, who she said was "wonderful and so supportive" and that her family and friends also helped her enormously.
She is now at university and says she is the happiest she has ever been, even though she thinks the impulse to self-harm will come back at times when she feels low, because it had become an addiction, a habit.
The charity YoungMinds says research it carried out with the Cello marketing group found that four in 10 young people do not know where to go for help and that one in three parents would not seek professional help if their child was self-harming.
The study, published in the autumn, found many teachers did not know what to say to young people who self-harm.
In England, the subject is often covered in Personal Social and Health Education lessons and normally, if teachers spot signs that young people are self-harming they will tell the school nurse or person responsible for child protection at a school.
One London teacher told the BBC News website she was surprised to be told by her school that if teachers spotted such signs they should "ignore them, because self-harming is a phase they usually grow out of".
"I didn't think that was right, as I would want to know if that was my child," she said. "And we might be able to get them to accept help."
Dr Singh agrees it would be wrong to ignore the signs.
"If someone is self-harming they are doing it in secret and are feeling emotional distress and that needs to be addressed.
"While it is true that a lot of young people do grow out of it, we should not ignore it."
He says the approach should vary depending on the people involved but that it is important to raise the issue in a way where the young person feels safe and secure, supported and "not judged".
Singer Tulisa said: "It's incredibly sad that so many young people are using self-harm as a way to deal with their issues and that many are suffering in silence. I've experienced difficult periods in the past but having somebody to talk to makes the world of difference."
That is a sentiment echoed by Bethany: "You might feel so embarrassed and worried what people might think or say, but the most important thing is to talk."