I don’t know what type of help I need, but help me.’”For Simelane, the pain began in the years after her mother died, when she was a young teen. “I was so grateful about how they responded.”Unbearable thoughtsFor some teens, emotional pain manifests as self-harm – including cutting, burning, hitting, biting, scratching and picking at skin. “They’re feeling emotional pain, and they’re expressing it almost as physical pain because they’re struggling to express it in words.”But, she emphasises, self-harm is not suicide . Compounded traumaBomikazi Lupindo , a psychologist and PhD candidate at Oxford University who trained in South African public hospitals, has been studying the mental health impact of violence on children. DMIf you or someone you know is struggling with self-harm or mental health issues, help is available.