It's important for anyone who self-harms to see their GP. They can treat any physical injury and recommend further assessment to find out why the person may be engaging in self-harm.
Your GP will 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
Your height, weight and blood pressure may also be checked. They may ask about any drinking or drug-taking habits.
It's important to be honest with your GP about your symptoms and your feelings. If you do not know why you self-harm, tell your GP this.
Get 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 or 112.
Emergency action required: Call 112 or 999 if you or somebody else:
- has taken an overdose of drugs, alcohol or prescription medicine
- is in a lot of pain
- is having difficulty breathing
- is losing a lot of blood from a cut or wound
- is in shock after a serious cut or burn
If you are not in immediate physical danger from your injury, you could go to an injury unit. These are run by doctors or nurses. They treat minor injuries, including minor burns and scalds, infected wounds and broken bones.
Your GP may refer you for further assessment. This can be with professionals in local community mental health services or other specialised services.
If you go to the emergency department (ED) after self-harming, you will:
- receive any necessary medical treatment
- have an assessment with a psychiatrist or psychiatric nurse before leaving hospital
This assessment may take place over several meetings. The purpose of the assessment is 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
- if you have thoughts of ending your life
You and a healthcare professional will discuss your treatment options and decide on a care plan.
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.
These kinds of treatments can be effective in the long term for people who self-harm.
Your treatment plan may involve medicine as well as taking therapy if you have a mental health problem such as:
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 reasons why you self-harm.
If you have lost a close relative or friend, 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 or bulimia. In this case, you may be referred to a counsellor who specialises in eating disorders and a dietitian.
Find out more about eating disorders.
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.
Content supplied by the NHS and adapted for Ireland by the HSE