Where to get help for self-harm
It's important to know that support is available for anyone who self-harms or thinks about self-harm, as well as their friends and family.
It's best to speak to a GP about self-harm, but you may also find it helpful to speak to a free listening service or support organisation.
Urgent help
If you need help now for a mental health crisis or emergency, read about where to get urgent help for mental health.
If you just need to talk, any time of day or night
Free listening services
There services offer confidential advice from trained volunteers. You can talk about anything that's troubling you, no matter how difficult:
- Call 116 123 to talk to Samaritans, – or email: jo@samaritans.org for a reply within 24 hours
- Text "SHOUT" to 85258 to contact the Shout Crisis Text Line
- Call 0800 585 858 to talk to Calm (if you're 15 years old or over) or use CALM webchat, both available from 5pm to midnight every day
- Call 0800 068 4141, text 07860 039967 or email pat@papyrus-uk.org to contact HOPELINE247, available 24 hours a day
If you're under 19, you can also call 0800 1111 to talk to Childline. The number will not appear on your phone bill.
These services will only share your information if they are very worried about you or think you are in immediate danger.
Speak to a GP if:
- you're harming yourself
- you're having thoughts about harming yourself
- you're worried about minor injuries, such as small cuts or burns – without treatment there is a risk of infection
Some people who self-harm are at a higher risk of suicide.
It's important to get support or treatment as soon as possible to help with the underlying cause and prevent suicidal thoughts developing.
How a GP can help with self-harm
A GP will listen and discuss the best options for you, which could include self-help or support groups. They can also give you advice and treatment for minor injuries.
They may ask you detailed questions to help them understand the cause of your self-harm. It's important to be honest with them, even if you do not know why you self-harm.
If needed, a GP may discuss referring you for an assessment with a local community mental health team (CMHT). An assessment will help your care team work out a treatment plan with you, such as a talking therapy, to help you manage your self-harm.
If you're under 18, you may be referred to your local children and young people's mental health services.
Further information and support
These organisations offer information and support for anyone who self-harms or thinks about self-harm, or their friends and family:
If you struggle with suicidal thoughts or are supporting someone else, the Staying Safe website provides information on how to make a safety plan. It includes video tutorials and online templates to guide you through the process.
Why people self-harm
Self-harm is when somebody intentionally damages or injures their body.
Some of the reasons that people may self-harm include:
- expressing or coping with emotional distress
- trying to feel in control
- a way of punishing themselves
- relieving unbearable emotional distress
- a cry for help
- a response to intrusive thoughts
Self-harm may be linked to bad experiences that are happening now, or in the past. But sometimes the reason is unknown.
The reasons can also change over time and will not be the same for everybody.
Common causes of emotional distress
Self-harm is most often described as a way to express or cope with emotional distress.
There are many possible causes of emotional distress. It's often a build-up of many smaller things that leads people to think about self-harm.
Some examples include:
- being bullied
- pressure at school or work
- family arguments or relationship problems
- money worries
- low self-esteem
- struggling with stress, anxiety or depression
- confusion about sexuality
- grief after bereavement or loss
- physical or sexual abuse
- being in contact with the criminal justice system
- experiencing complex mental health difficulties that sometimes cause impulsive behaviour or difficulty controlling emotions, often due to past trauma
- living with conditions such as attention deficit hyperactivity disorder (ADHD) or autism
Self-harm and suicide
There is evidence of a clear link between suicide or suicidal thoughts and people who have previously self-harmed.
However, not everyone who self-harms wants to end their life. Some people describe their self-harm as a way of staying alive by responding to or coping with severe emotional distress.
It's important to find the right support or treatment to help deal with the underlying cause in a less harmful way.
Further information and support
Ways to avoid self-harm
Finding ways to prevent or distract yourself from self-harm may help you get through a difficult moment.
However, it's very important that you get the support and treatment that you need to help address the underlying cause.
It can feel like a big step to speak to someone you do not know about your feelings or experiences. But with support it may feel easier to make changes that help reduce or stop your self-harm.
Ways to help avoid self-harm
Do
- try talking about your feelings to a friend, family member, trained volunteer or health professional. You could contact Samaritans, call: 116 123 or email: jo@samaritans.org if you need someone to talk to
- try working out if feeling a certain way leads to your self-harm – for example, when you're feeling sad or anxious you could try expressing that emotion in a safer way
- try waiting before you consider self-harm – distract yourself by going out for a walk, listening to music, or doing something else harmless to keep you busy; the need to self-harm may begin to pass over time
- try calming breathing exercises or other things you find relaxing to reduce feelings of anxiety
- write down your feelings – no one else needs to see it
- read about mental health and wellbeing – including help for common feelings such as stress, anxiety and depression
- if you struggle with suicidal thoughts, it may help to make a safety plan to use if you need it – the Staying Safe website has a guide on how to make a safety plan
Further information and support
How to tell someone about self-harm
It can be difficult to know how to talk to your friends, family or a health professional about self-harm. But many people feel more supported and less alone after talking to someone.
Tips to help you tell someone about self-harm
Do
- find someone you can trust – such as a close friend, family member, trained volunteer or health professional
- decide on the right time or place to talk to someone – it may feel easier to write something down, talk online or call and practise what you want to say first
- let the person know that what you're sharing may be a shock to them, but you're looking for help – ask to continue the conversation another time if the other person feels distressed or you're interrupted
- try to talk honestly and openly – be clear about how you're feeling, why you're asking for help and things they may be able to do
- let the other person ask questions – but do not feel you have to answer them all right now
- decide if you want to show the other person any injuries or scars – if you're talking to a health professional they may want to check if you need treatment
Further information and support
The mental health charity Mind has more information on how to talk to someone, on their website:
Assessment and treatments
If you talk to a health professional such as a GP about self-harm, they'll listen and discuss the best options for you. This could include self-help or support groups. They can also give you advice and treatment for minor injuries.
A GP may also offer you an assessment with a local community mental health team (CMHT).
This assessment is so the team can help you find the right treatment and support to reduce or stop your self-harm.
What happens during a self-harm assessment
During an assessment for self-harm, you may be asked about:
- what may have led to your self-harm
- how you feel afterwards
- your relationships and living arrangements
- anything you've tried to help reduce your self-harm
- any injuries that may need treatment
- whether you think you'll self-harm again
- whether you have thoughts of ending your life
- whether you're taking any medicines
- how much alcohol you drink or any drugs you're using
If an assessment suggests that support and treatment would be helpful, your care team will discuss the best options with you.
If the team does not feel that treatment is necessary, they can also offer advice on self-help or ways to manage the underlying causes.
Your care plan
After your assessment, your care team will develop a care plan with you. This will explain the type of support and treatment you need and how this will be provided.
The care offered will depend on what you need. It can include talking therapies and medicine that may help.
Talking therapy
Your care plan may include a talking therapy, which can be helpful after self-harm.
There are lots of different types of talking therapy, including:
All types of talking therapy involve working with a trained therapist who will keep your feelings and experiences confidential.
Therapy sessions may be face-to-face, online, over the phone, with your family, or with your partner.
Medicine
Your care team may suggest medicine as an option alongside talking therapy if you've been diagnosed with a condition such as depression or schizophrenia.
Your care team should give you emergency contact details in case you need to speak to them during or after your care.
Specialists involved in your care
During your assessment or treatment, the following health professionals may want to speak to you:
- a social worker
- an occupational therapist
- a counsellor – somebody trained in talking therapies
- a community mental health nurse – a nurse with specialist training in mental health conditions
- a psychiatrist – a qualified medical doctor with further training in treating mental health conditions
- a psychologist or psychological therapist – a health professional who specialises in the assessment and treatment of mental health conditions by helping you talk and express your feelings
You may see other specialists if your care team thinks it could help to address an underlying cause of your self-harm.
For example, you may be referred to:
You may also be recommended a self-help group, such as:
Further information and support
How to help someone else
If you think someone you know has started to self-harm, it's important to approach the subject with care and understanding.
It can be very helpful to just be there and let them know they're not alone. But it's important to remember you may not be able to help them on your own.
How to recognise self-harm
It can be hard to recognise when someone has started to self-harm as they may not want anyone else to know.
There are also many different ways that someone might self-harm.
Physical signs of self-harm
- keeping themselves fully covered at all times, even in hot weather
- unexplained cuts, bruises or cigarette burns, usually on the wrists, arms, thighs and chest
- unexplained blood stains on clothing or tissues
- signs that they have been pulling out their hair
Emotional signs of self-harm
- becoming very withdrawn and not speaking to others
- signs of depression, such as low mood, tearfulness or a lack of motivation or interest in anything
- signs of low self-esteem, such as thinking they're not good enough
- talking about ending things or not wanting to go on
Things you can try to help
There are some things you can try that may help someone feel more supported and able to get help.
Do
- encourage them to speak to a GP or free listening service about self-harm
- ask how they would like to be supported
- let them know you're there for them
- tell them about their positive qualities
- try to understand their emotions and experiences, without judging them, rather than focusing on their self-harm
- consider that any amount of self-harm might be a sign that they're feeling extremely distressed
- let them be in control of their decisions, but get them medical attention if needed
Don’t
- do not try to force them to change what they're doing
- do not threaten to take away their control
- do not insult them, for example by saying they're attention-seeking
Further information and support
If you're supporting someone who self-harms you should also make sure you take care of yourself.
If you care for someone with a mental health condition who is 18 or over, you can ask the local authority for a carer’s assessment. This will help you access support and services if you need to.
These organisations offer information and advice for friends and family:
The information on this page has been adapted by NHS Wales from original content supplied by 
NHS website nhs.uk
Last Updated:
18/09/2024 11:56:24