Self-harm is when a person intentionally injures their own body, most often to cope with emotional distress. It is a sign of distress, not a diagnosis, and not attention-seeking. It is not the same as a suicide attempt, though the two overlap and it is linked to higher suicide risk.
Key points
- Self-harm is when a person intentionally injures their own body, most often to cope with emotional distress.
- It is a sign of distress, not a diagnosis, and not attention-seeking.
- It is not the same as a suicide attempt, though the two overlap and it is linked to higher suicide risk.
- NICE says everyone who self-harms should be offered a psychosocial assessment, not a risk rating.
- NICE recommends a CBT-informed therapy tailored for adults who self-harm, not medicine.
Symptoms
- Relief: tension builds with nowhere to go, then eases briefly; a way through numbness or feeling unreal.
- Self-punishment: a belief of deserving it, often after abuse or shame; control, when nothing else feels controllable.
- Communication of distress that cannot be put into words; some describe it as what keeps them going, not a suicide attempt.
Causes and risk factors
- Bullying, including online; pressure at school, university or work; family conflict, a relationship ending, or bereavement.
- Abuse, trauma and their after-effects; low self-esteem, anxiety and depression; isolation, poor physical health, money or housing problems.
- Not done to get attention or to manipulate people - NHS guidance calls that suggestion insulting.
Treatment
- A psychosocial assessment at the earliest opportunity, covering what the self-harm does for the person and what led up to it.
- Risk scales must not be used to predict future suicide or sort people into low, medium or high risk categories.
- A structured, CBT-informed intervention tailored for adults who self-harm, typically 4 to 10 sessions; drug treatment should not be offered to reduce self-harm itself.
When to speak to a professional
- Self-harm has become the way you cope, or you do not feel able to keep yourself safe.
- Get help the same day if you have injured yourself and need treatment, or are having thoughts of suicide.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.