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.
Your GP may ask you some questions to see if you have an underlying condition such as depression, anxiety or borderline personality disorder. If the way you self-harm follows a particular pattern of behaviour, such as an eating disorder, you may be asked additional questions about this.
Your height, weight and blood pressure may also be checked, and 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 treating in an accident and emergency (A&E) department, minor injuries unit or walk-in centre. For example, you may need to call 999 for an ambulance if:
- you or somebody else have taken an overdose of drugs, alcohol or prescription medication
- somebody is unconscious
- you or somebody else are in a lot of pain
- you or somebody else are having difficulty breathing
- you or somebody else are losing a lot of blood from a cut or wound
- you or somebody else are in shock after a serious cut or burn
If your injury isn't serious, you could be treated at a minor injuries unit (MIU). These healthcare services are run by doctors or nurses to assess and treat minor injuries, such as minor burns and scalds, infected wounds and broken bones.
NHS walk-in centres, where a nurse can treat you without appointment, are also available for minor cuts and bruises.
Find your local A&E department, MIU or walk-in centre.
After seeing your GP, they should offer to refer you for a further assessment with healthcare professionals at a local community mental health service.
If you've attended A&E after self-harming, you'll first receive any necessary medical treatment. You'll then be referred to a psychiatrist or psychiatric nurse for an assessment before leaving the hospital.
This assessment, which may take place over several meetings, is used to find out more about you and your self-harming behaviour. The results of the assessment will be used to help determine the 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've used to self-harm
- how often you self-harm
- any specific events or feelings that occur before you self-harm
- any things you've 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 jointly between you and your team of healthcare professionals. It will be a specific programme for you, according to your needs and what's likely to be effective. You'll be asked for your consent to treatment before any begins.
Your care plan
In most cases, psychological treatment (talking therapies) such as cognitive behavioural therapy (CBT) is recommended for people who self-harm.
This involves attending sessions with a therapist to talk about your thoughts and feelings, and 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.
If you have a mental health problem such as depression, borderline personality disorder or schizophrenia, your treatment plan may involve medication, as well as psychological treatment.
If psychological treatment is recommended, you'll usually have a number of sessions with a therapist.
Once treatment finishes, you and your care team should discuss steps you can take to deal with any further crises and you should be told how to contact your care team, if necessary.
Specialists involved in your care
During your assessment and treatment, there are a number of different healthcare professionals you may see, such as:
- a counsellor – somebody who is trained in talking therapies
- a psychiatrist – a qualified medical doctor with further training in treating mental health conditions
- a psychologist – a health professional who specialises in the assessment and treatment of mental health conditions by talking (usually CBT)
You may also see some other specialists, depending on the underlying reasons why you self-harm.
For example, if you've lost a close relative, you may be referred to a specialist bereavement counsellor for help coping with bereavement. If you're self-harming after an incident of rape, or physical or mental abuse, you may be referred to someone who is trained in dealing with victims of sexual assault or domestic abuse.
If you have another condition that's linked to your self-harming, such as anorexia nervosa or bulimia, you may be referred to a specialist in eating disorders and a dietitian or nutritionist.
It might also be recommended that you attend a self-help group, such as Alcoholics Anonymous if you're misusing alcohol, or Narcotics Anonymous if you're misusing drugs. These groups can offer support as you try to stop your self-harming behaviour.