More problem youths are mutilating themselves, said the Samaritans of Singapore.
About half of the 541 youths who used SOS's Email Befriending service last year have admitted to hurting themselves deliberately.
Though SOS does not keep track of the numbers over the years, it has noticed an increase of self-mutilation cases over the past year.
Such youths resort to cutting, biting, hitting and burning themselves.
Said Ms Christine Wong, executive director of SOS: "Self-harm usually indicates intense and overwhelming feelings, and most of the time it is a way for the person in distress to communicate these painful emotions.
"The emotional pain they are feeling is often so intense that they need to balance it with a feeling of physical pain. It is often a cry for help."
Deliberate self-harm can be dangerous, even when death is notintended.
"People who deliberately injure themselves may not be fully aware of the dangers of their actions," said Ms Wong.
Senior social worker Ms Rachel Yeo from Fei Yue Community Services said she, too, has noticed an increase in the number of such cases.
About 30 to 50 per cent of youths seen by her centre have self-harming or suicidal tendencies.
Is e-mail counselling sufficient to tackle such a serious problem?
Said Ms Yeo: "If they don't release their emotions through online counselling, they usually won't tell anyone else and their problems remain hidden.
"(E-mail counselling) is a good emotional outlet and, if helpful, can reduce the intensity and frequency of self-mutilation.
"However, it takes a much longer time over e-mail to solve the issues. It requires more sessions and the extent to which counsellors can do therapy is alsolimited."
Self-harm is a coping mechanism so stopping the act should not be the focus.
Instead, friends, family, and educators can show their concern and can look at alternative ways to relieve the distress, said Ms Wong.
This article was first published in The New Paper.