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Self-Injury in Africa: A Reality We Rarely Talk About

Self-Injury in Africa: A Reality We Rarely Talk About

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By Veronica Wanyee

Why Self-Injury Awareness Day

On March 1st, many people around the world observe Self-Injury Awareness Day. This is a day held to shed light on a complicated experience that is lived both openly and privately. Self-injury is often misunderstood and deeply stigmatised and this further contributes to feelings of isolation and shame for those who may be undergoing distress. One of the more poorly understood aspects of this experience is Non-Suicidal Self-Injury (NSSI). This is the harming of one’s own body without the intention of causing death (Collings et al., 2025). For many people, especially young people, NSSI is a lot more complex than reckless injury, rather, it is a response to intense psychological pain and other stressors and a way in which people navigate survival that becomes a coping cycle which can be difficult to walk away from (Axame et al., 2024; Meheli et al., 2023). When we center lived experience, we can begin to see why this day is so important.

I. Understanding The African Context

A high volume of research on self-injury is focused in High Income Contexts but this limits our ability to appreciate its prevalence in Africa as well. While culturally ingrained stigma might see many people dismiss Self-Injury as a Western issue it is very much an African experience as well. In one study in South Africa, researchers looking at a sample of over 600 students found that over 55% engaged in self-injury behavior (Naidoo, 2019) and in a recent national survey in Kenya, over 40% of adolescents expressed having experienced a mental health disorder with only a fraction of this number having accessed mental health services (APHRC et. al, 2022). There is a high need for support in this regard.

More than just numbers are the stories and descriptions that come from speaking to people living through this experience. In Ghana, young people describe self-injury as not only a way to deal with emotional pain but also with loneliness, economic pressure and loss; some described their “shattered dreams” and the heartbreak of unrealised education goals due to financial hardship (Axame et al., 2024). Self-Injury is not “attention-seeking” behavior but a real response to complicated realities and this tells us that the support required must target many different factors at the same time.

II. Stigma, Community and Missing support

Stigma creates a significant barrier both to our understanding of self-injury and to recovery. A significantly high number of young people in Kenya (around three-quarters) will turn to their family as their first point of contact and yet most guardians and caregivers also report not knowing how to handle their child’s emotional crisis, leaving around 24.1% of young people preferring to deal with the issue in isolation to avoid associated stigma (APHRC et. al, 2022). Others, about a third, will seek help from religious services and another third from school staff (APHRC et. al, 2022). Healing becomes more possible when the collective community is aware of these realities and is equipped to respond with compassion and care.

Some of the barriers to recovery and understanding include: Traditional and spiritual beliefs that condemn individuals, where mental health becomes spiritualised, leading, in some cases, to abuse (Axame et al., 2024). Historical trauma and marginalisation are also factors, for example in South Africa, where experiences of poverty and discrimination contribute to ongoing stress (Collings et al., 2025; Collings & Valjee, 2025). Additionally, where family systems have inadequate styles of communication, NSSI can become a sort of language for the need for support, a way of asking for reassurance and care without the use of words (Collings et al., 2025; Naidoo, 2019)

III. Recovery as a Journey

According to research by Meheli et. al (2023), recovery is a journey and rarely occurs through linear, predictable patterns. It is important to understand that this will look and be defined differently for each individual depending on their specific situation. This work also helps us better understand some factors that might facilitate healing:

  • Some theories suggest that a higher percentage of people who engage in NSSI are in the “contemplation phase”. This means that they understand the impact of self-injury but feel conflicted as it has become a coping strategy.
  • A common motivating reason to stop is to protect loved ones from distress and worry. This alone, though powerful, is not enough on its own.
  • Many people also share that they would like to stop so they can feel more in control of their emotions and life and to break a cycle of heavy feelings.
  • Another motivator may also be wanting physical scars to heal and a desire to have a kinder relationship with one’s body.

However, recovery is not only about stopping the behavior, but also about fostering psychological wellbeing and receiving holistic support in the longer term. Some people may journey into recovery by first trying some harm reduction techniques with the help of trained professionals. Many people who receive appropriate support achieve full remission (Reichl et al., 2023).

IV. A Call for Understanding and Compassion

Self-injury Awareness Day is an important time to reflect and gain a more nuanced understanding of our mental health and the support we can offer those around us. It calls us to think about an experience that is often hidden under layers of myths and stigma. On this day some people may choose to wear orange or draw a butterfly on themselves as a symbol for hope. We encourage you to observe this day and to find further resources with more information on the subject, such as our ongoing Safe Space Podcast series on Suicide. If you or anyone you know is dealing with self-injury or mental health distress, it is important to seek out support. You can see our Therapy Resources Catalogue for some examples of where to seek help.

References:

African Population and Health Research Center, University of Queensland, & John Hopkins Bloomberg School of Public Health. (2022). National Adolescent Mental Health Survey (K-NAMHS). APHRC. https://aphrc.org/wp-content/uploads/2022/10/K-NAMHS-report_2022.pdf 

Axame, W. K., Kpodo, L., Bilabam, J. K., Assiam, R., Kugbey, N., & Gbogbo, S. (2024). Understanding adolescent self-harm attempts in Ghana: A qualitative analysis of family and social risk factors. BMC Psychiatry, 24(1). https://doi.org/10.1186/s12888-024-06279-w 

Collings, Steven J., Valjee, S. R., & Rowlett, D. (2025). Non-Suicidal Self-Injury among Adolescents and Young Adults in Africa: A Multi Method Systematic Review. https://doi.org/10.20944/preprints202508.0968.v1 

Collings, Steven John, & Valjee, S. R. (2025). The CO occurrence of non suicidal self injury and suicide attempts in a non clinical sample of South African adolescents. Epidemiology & Public Health, 3(2). https://doi.org/10.52768/3065-0011/1080 

Meheli, S., Bhola, P., & Murugappan, N. P. (2023). Reasons for recovery and readiness to change among adolescents and young adults engaging in self-injury. Industrial Psychiatry Journal, 32(2), 288–296. https://doi.org/10.4103/ipj.ipj_210_22 

Naidoo, S. (2019). The prevalence, nature, and functions of non-suicidal self-injury (NSSI) in a South African student sample. South African Journal of Education, 39(.), 1–10. https://doi.org/10.15700/saje.v39n3a1697 Reichl, C., Rockstroh, F., Lerch, S., Fischer-Waldschmidt, G., Koenig, J., & Kaess, M. (2023). Frequency and predictors of individual treatment outcomes (response, remission, exacerbation, and relapse) in clinical adolescents with nonsuicidal self-injury. Psychological Medicine, 53(16), 7636–7645. https://doi.org/10.1017/s0033291723001447