I sat in an empty classroom at a Christian international school. A tenth-grade girl perched on a desk, head lowered, hair covering her face, heels kicking back and forth.
Her parents were missionaries. Her mother taught at the school to cover tuition. Earlier in the day, another teacher noticed fresh cuts high on her thigh. It wasn’t the first time.
She said she was okay. She said she’d stop. They didn’t believe her. They knew she needed to talk to someone. She refused to see the guidance counsellor – but said she’d talk to me.
She didn’t look at me as she explained her perspective, trusting me to understand. She didn’t want anyone to worry. She really was okay. She had no intention to actually hurt herself.
Cutting gave her clarity. It quieted the chaos of her emotions long enough for her to focus on schoolwork. It wasn’t the first time a teenage TCK had told me that.
Missionary Kids and Self-harm
Mental health challenges are common among missionary kids. Naming this does not mean we need to panic – and there is good news. Before we discuss the good news, let’s look at the stats.
According to TCK Training’s 2024 survey of 1,643 TCKs, 83% of missionary kids experienced symptoms of at least one mental health concern during their lifetime. Among Gen Z missionary kids, 79% experienced symptoms during childhood (before age 18).
Self-harm is defined as intentionally causing harm to oneself, whether or not there is suicidal intent. A large portion of self-harm falls under non-suicidal self-injury (NSSI), which includes behaviours such as cutting or burning.
A 2019 study spanning 41 countries found that around 22% of children and adolescents globally had engaged in self-harm, with onset most commonly around age 13. Cutting was the most frequent method (Lim et al., 2019).
When we compare this to what missionary kids report, we see:
- 22% of children globally self-harmed before age 18.
- 18% of missionary kids overall self-harmed before age 18.
- 29% of Gen Z missionary kids self-harmed before age 18.
While these are different studies with different parameters, the message is clear: The missionary lifestyle does not provide immunity from self-harm or other mental health challenges.
Effective Prevention of Self-harm
These numbers are sobering, but they are not the end of the story. There are things we can do now to lower the risk of self-harm in our missionary kids.
TCK Training’s research consistently shows that Positive Childhood Experiences (PCEs) are strongly associated with lower rates of self-harm among TCKs, including missionary kids.
- Missionary kids with 5-7 PCEs were 59% less likely to self-harm in childhood than those with 0-4.
- Only 7% of missionary kids with all 7 PCEs self-harmed during childhood.
- Gen Z missionary kids with all 7 PCEs were 82% less likely to self-harm than those with 0-2 PCEs.
PCEs have a huge impact, but they are not magic nor are they overly complicated. They are just indicators of emotionally safe homes, supportive friendships, and connected communities.
From a TCK’s point of view, the seven PCEs are:
- I receive emotional support at home (my feelings are heard and accepted).
- My family stands by me in difficult times.
- An adult in my home makes me feel safe and protected.
- There are two non-parent adults in my life who take a genuine interest in me.
- I enjoy participating in community traditions.
- I feel supported by friends.
- I feel a sense of belonging during my teen years.
Each one of these matters. They aren’t difficult, but they require intentionality – especially when global mobility and cross-cultural living is involved. (Learn more about PCEs with this free course on Implementing PCEs.)
Responding to Self-harm
How adults respond to a struggling child matters, both before and after a child discloses. The way we talk about emotions, stress, faith, and struggle teaches children whether we are ‘safe’ people with whom to share their inner struggles. Many young people ‘test’ potential helpers by sharing smaller concerns first. If those are brushed off, the larger problems stay hidden.
Most TCKs I’ve worked with who self-harmed fell into the non-suicidal self-injury (NSSI) category. They knew it wasn’t exactly healthy, but believed it was the least harmful way they knew to cope. That means our first response should not be panic or control, but curiosity. (That’s one of the four Safe Space Responses – access a free course on them here.)
Trying to stop behaviour without understanding why it developed rarely leads to lasting change. Non-judgmental listening allows us to uncover the emotions underneath and opens the door to healthier coping strategies. Next we connect the young person and their family with professional support, a crucial tool for long-term wellbeing.
That’s what I did in that classroom. I listened. I asked questions. I helped her imagine a life where the stress didn’t pile so high she felt she needed a blade to get through it.
Together, we created a plan: mentoring, regular counselling, and a mediated meeting with the school to reduce academic pressure. Then we shared that plan with her mother.
Anyone Can Learn to Support an MK in Need
For anyone who regularly spends time with missionary kids – whether pastors, teachers, mentors, family friends, and even parents themselves – training matters. You don’t need to become a therapist, but you do need tools. I highly recommend both Youth Mental Health First Aid for TCKs and Suicide Intervention for TCKs.
To go deeper, there is Groundwork for anyone who interacts with TCKs regularly, which includes both the YMHFA and Suicide Intervention certifications, and TCK Crisis Care Training.
Because missionary kids don’t need us to be perfect. They need us to be prepared when they are ready to reach out.
Note: If your family or a family you care about is in crisis, don’t wait. You are not alone, and support is available. Finding a licensed therapist your child feels comfortable with is critical for long-term wellbeing. Here is a great list of TCK-informed therapists you can refer to for assistance. The Season of Crisis Toolbox is also a great starting point for working out how to support your family as a whole while navigating difficult seasons together.
