Note: names have been changed and no school has been identified to protect the identity of the child and her family.
It was the shock of a lifetime when Lori, the mother of a 12-year-old girl from Conception Bay North, saw self-inflicted scrapes and scabs on her daughter's arm.
The Grade 7 student was feeling stressed after a conflict with a classmate and had heard about coping mechanisms that included self-harm.
Kerri had started cutting herself in November, after a dramatic start to the school year. She was called names and harassed by other students.
Lori and Kerri's older sister Natalie never suspected the girl would ever hurt herself. She was a happy, positive and smart girl - or so they thought. When they learned she had turned to cutting, they immediately brought her to Carbonear General Hospital to get assessed.
During a conversation, they learned several students in the school had confided in Kerri that they too were cutting.
After Kerri's discharge, Lori and Natalie reached out to The Compass to raise awareness and reach out to other parents in the region.
Lori and Natalie met with The Compass separately last week. Each had their own response to learning about Kerri's situation. Kerri wasn't prepared to talk openly about it yet.
It was Kerri's sister who first noticeed the marks on her arm. Natalie came across them by accident.
"We were playing around, and I grabbed her wrist," she told The Compass. "When she pulled away, I could see the marks."
Immediately, she went to tell her mom what she had seen, and Lori couldn't believe it.
"At first I thought it was a joke," Lori explained. "I said for them to stop joking. It's not something to joke about."
When Kerri started to retreat, Lori knew something was wrong.
"I said, 'Let me see it now,'" she said. "And then I broke down crying."
Kerri was given two choices - go to the hospital with her mom, or have an ambulance take her there. She chose the former option. Natalie was still confused about why Kerri would hurt herself.
"It didn't make any sense to me," she said. "There were no signs."
But Kerri found ways to hide those signs. She kept her arms hidden from her family, hid her feelings about being picked on and continued on as if everything was fine.
Hundreds of patients
From Feb. 1 2014 to Jan. 31 2015, 526 patients were seen at the Janeway Children's Health and Rehabilitation Centre for depression, suicide and self-harm. The Janeway is the province's only children's hospital. It treats patients from birth to 17 years old.
According to an email from Eastern Health spokesperson Angela Greenslade, the health authority's policy since 2012 has been for every case related to depression or self-harm to be assessed by a psychiatric nurse. If necessary, they may also be assessed by a psychiatric resident.
In some cases, children get admitted to the hospital, while others may be referred to the Child Central Intake program.
A child can also be referred themselves or by a family member by calling 777-2200 from Monday to Friday 8:30 a.m. to 4:30 p.m.
"Eastern Health monitors trends related to reasons for presenting to emergency departments and, on a case-by-case basis, is committed to educating patients and clients about the risks associated with self-harm," Greenslade said.
Lori is waiting on a referral for Kerri, so she can talk to someone about her situation.
Kerri told her mom and sister several of her friends were also involved in cutting. They researched how to do it on websites like VINE and YouTube.
"You wouldn't believe what they are finding on there," Natalie said.
The Compass also spoke with parents and students from the Conception Bay North region, and learned this may not just be a one-school situation.
One parent knew of five girls that admitted to self-harming themselves in her child's junior high school class.
Another parent said she and others have been hearing about it for months, but no one knew who was taking part or if it was just a rumour.
The Newfoundland and Labrador English School District said school health curriculum includes discussions on mental health appropriate for each individual age group, including but not limited to expressing feelings in appropriate ways and a Have Fun Friends program to curb bullying.
Lucy Warren, the assistant director of programs for the district's eastern region, said the Internet and smart phones allow youth to access information of all sorts.
"The new digital age contributes to that," she told The Compass. "Students can share information with each other. They can use the internet to learn more."
Lori and Natalie had a long talk with Kerri about cutting, and now that she is no longer doing it, they feel parents need to be educated on the subject.
"At first I thought I may have been responsible, and I asked, 'Did I do something wrong?'" Lori said.
She now knows that isn't true, but still fears for her daughter.
"I'm constantly checking her (arms)," she said.
But the injuries are not just limited to arms, but also legs, ankles below the socks, hips at the underwear line and the ribs. Some children cut until they leave a mark, others cut until they bleed.
"If I could tell parents one thing, it would be to check your kids," Lori continued. "Even if you think your child couldn't do it, you should check. I didn't think mine could, and she did."
Natalie wants parents and teachers to be aware of the tools that some kids are using, especially since many may believe they are harmless.
Kerri used the blade from a sharpener. Other items people may want to keep an eye out for are nails and screws, fingernail clippers, safety pins and push pins, keys and anything metal or plastic that could have a sharp edge.
An article with information from a clinical psychologist who has experience dealing with self-harm and depression will appear in the March 16 print edition of The Compass.