What is self-harm?

Self-harm is when you hurt yourself to try to deal with distressing feelings. There could be a lot of different reasons for self-harm, for example trying to cope with anxiety or depression, or if you feel like you need to punish yourself. Self-harm is not an illness itself, but it’s a sign of other difficulties that you could get help with.

How can I get help? 

Visiting your GP

You can talk to your GP about getting help for self-harm. They should ask you about your self-harm and how you’re feeling, and will be able to refer you to specialist mental health support. Depending on where you live, your school or college might also be able to refer you to these services, and in some areas you can refer yourself. You can find more information about mental health referrals here and more information about local mental health services here.

If you have self-harmed recently, your GP may recommend that you have further treatment. This could involve:

  • treatment for physical injuries
  • taking blood or other samples if you’ve overdosed or poisoned yourself
  • an urgent referral to a mental health service
  • transfer to an emergency department
  • a member of staff staying with you if you’re very distressed

Treatment by ambulance services

If you’re treated by ambulance services after self-harm, the ambulance staff should talk with you about what happened and about how you are feeling. Whenever possible, they should discuss any treatment that you might need with you. You might be taken to an emergency department for further treatment. If you have poisoned yourself, ambulance staff should take all the substances or drugs that they find to the emergency department. This could be important to make sure you get the right treatment.

If you don’t need treatment at an emergency department, the ambulance staff could take you to a specialist mental health service. The ambulance and mental health professionals should talk with you about these options and listen to your views.

Visiting an emergency department

As well as assessing your physical health, emergency department staff should talk with you about how you are feeling and the risk you might pose to yourself. If you need to wait for treatment, you should be offered somewhere quiet that is safe and supportive, for example with someone to be with you and regular contact with staff.

If you’re under 16 years old you should be treated in a separate children’s area. If you have poisoned yourself, emergency department staff should collect samples (usually blood) from you to find out what you’ve taken and how much. This is important for them to give you the best treatment.

Emergency department staff should give you clear information about your care and should encourage you to stay for an assessment. An assessment would include talking about:

  • whether you are able to make decisions for yourself
  • if you’re willing to stay for a mental health assessment
  • your level of distress
  • if you could have a mental health condition

If you’re 8 to 16 years old, you could be admitted to a children’s ward overnight after self-harm and then have an assessment with a Child and Adolescent Mental Health Service (CAMHS) professional the next day. If you’re over 14 years old, you could be admitted to an adolescent ward if you prefer.

If you want to leave but emergency department staff don’t believe you are able to make that decision, or if you have a significant mental health condition, you should be referred for an urgent mental health assessment. If necessary, staff might stop you from leaving to protect you from further harm.


A mental health assessment will help your professional to understand your self-harm and other important parts of your life, such as your family or school life. As well as speaking to you, your professional might also talk with your family and any other professionals who might be able to help (e.g. your teachers).

Your professional should work with you to understand your self-harm and any mental health or other needs you might have, including:

  • any mental or physical health conditions you might have
  • any current life difficulties (e.g. personal or financial problems)
  • your day-to-day functioning
  • your social circumstances
  • your coping strategies
  • your skills and strengths

Your professional should encourage you to look through your assessment so that you can agree on the outcomes together. If you disagree about something with your professional, then you should be able to write this in your notes. Your mental health professional should share information about your treatment plan with your GP and any other relevant mental health services.

Planning treatment

If you are referred to specialist mental health services, your professional should give you information about self-harm and explain the support that’s available. Whenever possible, you should continue having support from one professional, rather than having to talk to lots of different people.

Your professional should create a care plan with you based on your assessment. Your care plan should not just focus on self-harm, but should help you with the underlying problems or mental health difficulties that are causing you distress (e.g. depression, borderline personality disorder, conduct disorder, post-traumatic stress disorder or an eating disorder such as anorexia, bulimia or binge eating disorder).

If you are over 16 then you will usually make decisions about your treatment, for example which option you prefer if there are a choice of treatments and how much you would like your parents or carers to be involved in your treatment. You don’t have to make these decisions on your own though, many young people aged over 16 decide that they would like support from their parents or carers when making decisions about treatment.  

Some young people under the age of 16 will also be able to make treatment decisions on their own, but if that’s not possible then your parents or carers will be asked to make decisions for you. However, even if your parents or carers make decisions about your treatment, your mental health professional should still listen to your thoughts and preferences about the treatment options. You can find more information about how these decisions are made here and read more about shared decision making here

You and your professional should work together to agree on the aims of your care, which could include things like:

  • reducing or stopping self-harm
  • reducing how severely you harm yourself
  • reducing other risky behaviour
  • improving your social and day-to-day functioning
  • improving your quality of life
  • improving any other mental health conditions you may have
  • long-term goals (e.g. your education or employment goals)

You should receive support from specialist services to help you achieve these aims and your professional should help you understand the steps you need to take. Your care plan should be reviewed and updated at least once each year and shared with your GP.

Your professional should explain your treatment options and how each might help. They should also talk with you about:

  • the benefits and risks of the treatment options
  • any worries you have
  • any other physical or mental health conditions you have

Your professional should also tell you about other organisations which offer support and information. For example, YoungMinds and Harmless.

Risk management plans 

To help keep you safe, your professional should work with you to make a risk management plan. This should include: 

  • your history of self-harm 
  • how you feel when you self-harm 
  • if you’ve ever thought about suicide 
  • if you have symptoms of depression  
  • if you have any other mental health conditions 
  • personal problems (e.g. relationship problems, family problems or problems at school) 
  • your support system (e.g. family, a partner or friends) 
  • if you engage in risky behaviour (e.g. alcohol misuse, drug-taking or unprotected sex) 

This should include a crisis plan, which will give you advice on how to get help if you’re having a mental health crisis and methods to help you cope. 

If stopping self-harm is unrealistic in the short term, you may be offered strategies aimed at harm reduction. This could reinforce coping strategies you already use and help you develop new strategies as an alternative to self-harm. Your mental health professional may also discuss less harmful methods of self-harm with you and your parents or carers, if you agree. If you self-poison you should be advised that there is no safe way to do this. 

What about my parents or carers?

Your parents or carers could play an important role in your treatment and your professional should talk with you about how you would like them to be involved. Your professional should give your parents or carers information about self-harm and what they can do to support you. Your professional should also give your parents or carers contact details for services which can help during a crisis. 

The well-being of your parents or carers is important, and they may need support and advice themselves. Your professional should help your parents or carers to access a carers assessment, to look at support specifically for them. Your parents or carers should also be given information about support groups and organisations, such as the NSPCC or YoungMinds.  

Transitions between services

Transitioning from CAMHS to adult services can be a worrying time. To help it go smoothly, your professional should leave plenty of time to work with you to plan the change. You should get clear information about what to expect from adult services and it can be helpful to involve your parents or carers in the process. 

You should be given additional support with the transition if you need it and clear plans in case of a crisis. Your current and new mental health teams should work together to reduce any negative impact of transferring between services. This should include timing the transition to suit you, even if that means transitioning to adult services after your 18th birthday. You may also be offered continuing treatment in child and adolescent services if that would mean you could avoid being referred to adult services altogether. 

You may also transition to another CAMHS service (e.g. if you move house). If this happens, your professional should work with you to make sure that your treatment can continue smoothly and that your new service has all the information they need. 

For more information about transitioning between services, please see Moving on.

Additional support

The below organisations offer self-harm specific support for children, young people and their families:

  • AFC Crisis Messenger: a free, confidential, 24/7 text message support service for anyone who is feeling overwhelmed or is struggling to cope. If you need support, you text AFC to 85258
  • Childline: Childline is there to help anyone under 19 in the UK with any issue they’re going through. Whether it’s something big or small, their trained counsellors are there to support you
  • Harmless: charity supporting those who do or are at risk of self-harm
  • Lighthouse: charity committed to the prevention of self-harm and suicide based in Northern Ireland
  • Makespace: Community interest company (CIC) who create peer-led spaces for people with experience of self-harm to come together and share their experiences
  • Samaritans: offering self-help support to those who do or are at risk of self-harm. They have websites offering support in Northern Ireland, Scotland and Wales
  • Self-injury support: charity offering support for girls and young women be phone, email, text or webchat
  • Supportline: charity offering helpline for people of all ages on a wide range of issues including anger, eating disorders, self-harm, depression, anxiety, panic attacks, and addictions
  • The Mix: support and advice for children and young people under 25
  • Youthscape (previously Self-harm UK): charity offering free online support for those who self-harm or are worried they might

Treatments outlined on these webpages may not be available in every local area. It’s important that you discuss with your GP or mental health professional the treatment options available to you. You can also search for services near you on our Youth Wellbeing Directory and find out more about referral processes here.

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