First, you are a good friend being concerned and you are doing the right thing by seeking support for yourself and your friend, even if asking this question as a first step through this forum.

You are not unlike many people your age in that you value your relationship and therefore do not want to jeopardise that relationship by interfering, so you sit on the sidelines and basically go with the flow, albeit uncomfortably.

Echoing this posture was a great ground-breaking 2012 UK research project by the Cello Group in conjunction with Young Minds, which provided some interesting facts.

According to the research, of the 1002 young people aged between 14 and 24, more than 80 per cent said they would be very worried if they knew that a friend was self-harming, with a majority believing they should offer support but did not feel empowered to do so.

Further, four out of five stated they did not know where go with questions relating to self-harm. A total of 97 per cent felt that the topic of self-harm should be addressed in schools, with two out of three feeling self-harm should be part of their lessons.

Obviously, this research underscores a need to support young people in discussing the topic and moreover a need to be empowered to discuss self-harming among their peers in an open forum in the safe confines of a school classroom environment.

This research also highlights the need to talk more openly at a broad conceptual level to combat narrow views that exacerbate stigma.

For many people there are other underlying mental health factors that contribute to a person self-harming, such as an intellectual disability, acute psychosis, childhood history of physical or sexual abuse or a personality disorder.

Therefore, the stimulus to self-harm can involve difficulty managing frustration or anger, hallucinations or delusions (in the case of those with acute psychosis), difficulty managing the symptoms of trauma such as intense emotional states, and the self-blame and self-loathing that often follows from abuse.

Also, alcohol or other substances may facilitate self-harming.

The Cornell Research Program in the US suggests there are a variety of motivations, triggers and circumstances of those who deliberately injure themselves.

They can be to release tension or frustration, express anger, to substitute emotional for physical pain, to be able to “feel something” when feeling emotionally disconnected, or sometimes to induce dissociation to avoid aversive emotion as is common in the case of abuse or trauma.

For some people who harm themselves, being able to feel physical pain or see one’s own blood can be comforting.

To answer the question of what can you do to help your friend, just simply being their friend and supporting them by showing you care is a start.

Encourage them to talk to an allied health professional (counsellor, psychologist, psychiatrist, medical practitioner) or even accompany them to appointments.

But, most importantly, you need to look after yourself, because if you become stressed or unwell mentally/physically you will not be in a position to support your friend.

So don’t be afraid to take time out for yourself and enjoy your life doing the things you enjoy doing. This will ensure you are mentally in a good place.

Dr Anthony Perrone is college counsellor at Trinity Anglican College. The views expressed are Dr Perrone's and not necessarily those of Trinity Anglican College.