It's important for anyone who self-harms to see their GP. They can treat any physical injury and recommend further assessment, if necessary.
Your GP is likely to ask you about your feelings in some detail. They'll want to:
- establish why you self-harm, what triggers it, and how you feel afterwards
- see if you have an underlying condition such as depression or anxiety
- see if the way you self-harm follows a particular pattern of behaviour, such as an eating disorder
Your height, weight and blood pressure may also be checked. You may be asked about any drinking or drug-taking habits.
It's important to be honest with your GP about your symptoms and your feelings. If you don't know why you self-harm, tell your GP this.
Seeking immediate help for an injury or overdose
Some physical injuries may need to be treated at an emergency department or injury unit. For example if somebody is unconscious, call 999.
You may also need to call 999 for an ambulance if you or somebody else:
- has taken an overdose of drugs, alcohol or prescription medication
- are in a lot of pain
- are having difficulty breathing
- are losing a lot of blood from a cut or wound
- are in shock after a serious cut or burn
If your injury isn't serious, you could go to an injury unit. These are run by doctors or nurses to treat minor injuries. These include minor burns and scalds, infected wounds and broken bones.
After seeing your GP, they could refer you for further assessment. This would be with professionals in local community mental health services or other specialised services.
If you have attended ED after self-harming, you will:
- Receive any necessary medical treatment
- Go for an assessment with a psychiatrist or psychiatric nurse before leaving hospital
This assessment may take place over several meetings. It's used to find out more about you and your self-harming behaviour. The results will be used to help decide what treatment and support you need.
During an assessment, you'll usually be asked about:
- your physical health
- your relationships with others and your living arrangements
- the methods you have used to self-harm
- how often you self-harm
- any specific events or feelings that occur before you self-harm
- any things you have tried to help reduce your self-harming
- whether you think you'll self-harm again
- why you think you're self-harming
- whether you have thoughts of ending your life
Any further treatment will normally be decided between you and a healthcare professional. It will be a specific programme for you.
You'll be asked for your consent to treatment before any begins.
Your care plan
In many cases, psychological treatment (talking therapies) is recommended for people who self-harm. Cognitive behavioural therapy (CBT) is one type of talking therapy.
This involves sessions with a therapist to talk about your thoughts and feelings. They can help you to see how these affect your behaviour and wellbeing.
Evidence suggests these kinds of treatments can be effective in the long term for people who self-harm.
Your treatment plan may involve medication, as well as psychological treatment, if you have a mental health problem such as:
- borderline personality disorder
When treatment ends, you and your care team should discuss ways you can deal with any further crises. You should be told how to contact your care team if necessary.
Specialists involved in your care
During your assessment and treatment, there are different healthcare professionals you may see, such as:
- a counsellor
- a psychiatrist
- a psychologist
You may also see some other specialists. This depends on the underlying reasons why you self-harm.
If you have lost a close relative, you may be referred to a specialist bereavement counsellor. They can help you to cope with bereavement.
Some people's self-harm begins after an incident of rape or physical or mental abuse. In this case, you may be referred to someone trained in dealing with victims of sexual assault or domestic abuse.
Some people's self-harm is linked to anorexia nervosa or bulimia. In this case, you may be referred to a specialist in eating disorders and a dietitian or nutritionist.
Drugs or alcohol
Some people's self-harm is linked to misusing alcohol or drugs. You might be advised to attend a self-help group. This could be Alcoholics Anonymous or Narcotics Anonymous. These groups can offer support as you try to stop self-harming.