Kids don't typically really want to harm themselves. A kid who winds up being suicidal they usually feel compelled. At that point in time they do want to die because they feel so terrible and it's the only way out. There are other reasons that children harm themselves. For some kids, it becomes a functional behavior. What I mean by functional behavior is that it gets them nurturance or it gets them love or it gets them attention either from peers or from parents. Neither the peers nor the parents are really equipped to make that differentiation. I would still get that child an evaluation.
Another reason why teens harm themselves is for peer recognition, particularly those who are cutters or those who are pokers. A lot of times it gains them status within their social network of other teens. There are some subtle shades of grey and white along this continuum and there isn't just one reason why kids do harm themselves. It's not always depression which usually precludes the most serious kinds of self-harm but you can be depressed and not self-harming. If you really are suicidal then you're probably also very depressed. Some of the other forms of self-harm, such as cutting or poking, does not necessarily mean that a child is depressed. It could be attention getting. Or it could be kind of a conduct problem that the child has in terms of using it for personal gain, manipulation, status, those kinds of issues.
