Explains self-harm, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.
What support and treatment is available?
Sometimes outside support is needed to help you make positive changes. You may need to try a few different things to find what works for you, and combine self-help techniques with professional support:
If you receive NHS treatment, it should be in line with National Institute for Health and Care Excellence (NICE) guidelines.
These say that:
- Any health professionals should treat you in a way that is sensitive and non-judgemental.
- Ideally, health professionals should be trained in communicating sensitively with people who self-harm, and be aware of potential stigma.
- Any treatment you are given should be tailored to your individual needs.
Seeing your GP is often the first step to asking for help and discussing your self-harm confidentially.
Your GP may:
- assess you and let you know about available treatment
- prescribe medication for anxiety or depression, or to help with sleeping
- refer to your community mental health team (CMHT) which can include psychiatrists, psychologists, social workers, an occupational therapist and community psychiatric nurse.
If they are concerned that your self-harm is a threat to your life, or if you need medical treatment for your injuries, they may suggest you spend time in hospital.
Visiting the GP was the best thing I have ever done. It didn’t immediately get better, but that’s where my recovery began.
Talking treatments involve talking with a professional therapist trained to listen with empathy and acceptance.
- Cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT) and psychodynamic therapy have been shown to be helpful for people who self-harm.
- If you can afford to, you can pay to see a private, trained and accredited therapist. See the British Association for Behavioural and Cognitive Psychotherapies (BABCP), the British Association for Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP) for further details.
See our pages on talking therapy and counselling for more information.
Support groups are regular meetings with others who have similar experiences to you.
- Support groups can be peer-led or facilitated.
- They may focus on specific issues or be more general.
Online support is an option if you don't feel ready to see someone face-to-face.
- Email, text, information or forum support is offered by self-harm services – for example National Self Harm Network, Self-injury Support, LifeSIGNS, The Mix and Sane.
- The content on some self-harm sites can be triggering. Make sure the sites you visit are well moderated and that you know how to protect yourself and others while online. See our pages on online mental health for helpful guidance on staying safe online.
Some people feel that scars from self-harm are an important part of their journey, while others would prefer not to have them. Treatments are available for covering and reducing scarring. For more information see the LifeSIGNS pages on scar reduction and skin camouflage.
Things to consider when asking for help
Remember that whoever is supporting you is there to help you and listen to you. Sometimes a therapist or practitioner may ask you to commit to not self-harm during a course of treatment. It is important that you don't feel pressured into making decisions about this, and that anything you decide is realistic for you at the time.
It can be tempting to try to cover up the extent of your self-harm, or to lie about it altogether. While this is understandable, if you are able to share your experience it can make a big difference to how you feel. It can help to reduce feelings of shame and isolation, and will increase the chance of you receiving the support you need. It does take a lot of courage to reach out, and it might take more than one conversation to say everything that you'd like to say.
Even when I've had to go to A&E, I have lied and pretended my injuries were accidents – which in hindsight is silly as I could have received some emotional support, but I hold such deep shame.
If the person supporting you is not trained or experienced in self-harm, it might be useful to ask them to find out more – by reading these pages, for example, or by contacting an organisation for people who self-harm (Self-injury Support, LifeSIGNS and Harmless have helpful information resources).
It can also help if you write down all the things that you'd like to say to the person in advance. This will help you if you feel anxious about expressing your feelings or worried that you might be judged.
I have noticed in recent years that nurses and doctors in A&E are more understanding of self-harm, which is great.
If you are concerned about your treatment or care, or find it hard to access the support you need, it may be helpful to get an advocate to support you. This could be a friend, family member or professional. You can also contact the Patient Advice and Liaison Service (PALS) for information on making a complaint about NHS services if you need to.