An alarming number of children are calling helplines because they are self-harming, warns a charity.
More girls than boys self-harm
ChildLine had more calls than ever before from young people about self-harm, an audit found.
It received nearly 4,300 self-harm calls, particularly from girls, an increase of 30% on the previous year.
A report by the Mental Health Foundation and The Camelot Foundation, which are running a national inquiry, said the trend was worrying.
The report took evidence from 150 young people and a number of organisations and charities including ChildLine.
The number of children speaking to ChildLine about self-harm has grown steadily over the last 10 years with an average annual rise of 23%.
During 2003/4, ChildLine counselled more than 4,000 young people who were self-harming - nine out of 10 of whom were girls.
More than three-quarters of the callers were aged 12-15 and for almost half said self-harm was an ongoing problem for them.
Some self-harmers were as young as five years old.
"Extreme" and "concerning"
This may only be the tip of the iceberg because self-harm is often hidden, according to research.
The National Inquiry and researchers at the University of London both found self-harm among young people often went unreported.
Many young people said they would not seek medical advice unless treatment was needed.
There was often a 'trigger' or circumstances that lead to the person to begin self-harming, such as an abusive relationship with a parent or being bullied at school.
Young people who self-harmed described feelings of powerlessness and despair, and said they turned to self-harm as a way of releasing emotion and tension or to gain a feeling of control.
Chair of the Inquiry, Catherine McLoughlin CBE, said: "Whatever a young person's reason for self-harming, we need to find out why an increasing number of young people in the UK are hurting their bodies in order to cope with their emotional problems.
"This behaviour is extreme and concerning."
Dr Carole Easton, chief executive of ChildLine, said: "The experiences of ChildLine's callers highlight the need for directly accessible, widely available and well-resourced child and adolescent mental health services."
In July this year the National Institute for Clinical Excellence said people who deliberately harm themselves were being offered inadequate treatment.
It published guidelines on best management of self-harm.
A spokeswoman from the Samaritans said: "Self-harm is a way of dealing with emotional pain in a physical way - like screaming without opening your mouth.
"Despite the fact that self-harm affects a large number of people, the stigma around it often prevents people from seeking help.
"Samaritans supports the national inquiry, and hopes it will help reduce stigma, and lead to a greater awareness of how to work with people involved in self-harm."