During an incident:
- Try to control your emotional reaction and respond in a neutral way to the person. Yelling or panicking may increase the person’s distress and could reinforce self-harm.
- If there are other people around, take the person to a more private place, so as not to attract unnecessary attention.
- Help the person to administer first-aid to his/her injuries. If the injuries are severe, call an ambulance or take the person to the hospital. Try to take the person to a facility where he/she will be treated sensitively.
- Ask the person if he/she is suicidal – it is important to either rule this out, or get the person appropriate mental health support if he/she is suicidal. See What to do in an emergency?
It is a myth that self-harm is done ‘just for attention’. Most people do it in private and hide their scars, as they feel ashamed and fear being thought of as ‘freaks’. The need for attention is a normal human motivation. The question to ask is: if the person is using self-harm as a way to communicate their distress, why is the person going to such desperate lengths to get attention?
It is helpful for the person to understand the reasons underlying his/her self-harm, as well as learning other ways of coping with self-harm thoughts and feelings.
DO
- Always take self-harm seriously.
- Try to remain calm and supportive. A person who self-harms is often very distressed and needs the support of both family and professionals.
- Retain an open attitude, as the person might feel ashamed by their behaviour and be worried that others will judge them. In doing this, you will hopefully create a caring space where the person feels safe enough to discuss their feelings.
- Listen to the person so he/she feels heard and supported, and take the person’s problems seriously.
- Encourage the person to talk about his/her feelings rather than self-harming. Explore with the person what other strategies he/she could use to cope, rather than self-harming.
- Find ways to enhance the person’s self-esteem and acknowledge his/her positive qualities.
- Encourage the person to seek professional help. It is vital that the person receives appropriate health care that is sensitive, skilful and non-judgmental. Ongoing support delivered in this manner could reduce the person’s self-harming behaviour and therefore also reduce the likelihood of accidental death.
- Assist the person to access professional support. Suggest options for support and offer to accompany the person to an appointment. Your local GP can advise about specialist mental health professionals who can help.
- Ask if the person is suicidal. It is important to check this out.
- Call an ambulance or take the person to the local hospital emergency department if they need urgent medical attention.
- Get support for yourself as well – caring for someone who self-harms can be emotionally demanding and stressful.
DON’T
- Panic, become angry, reject the person, or take the person’s self-harming behaviour personally. Such reactions may create feelings of guilt and shame for the person.
- Condone self-injury. At the same time, try to be non-judgmental and let the person know you will support him or her to find alternatives to self-harm.
- Remove self-harm as a coping strategy without first replacing it, as this increases the person’s vulnerability to life difficulties.
- Give ultimatums. This could increase feelings of rejection for the person and decrease trust between you, as the person may feel unheard. This could result in the person feeling unsupported and withdrawing from you. The motivation for change must come from within the person.
- Pressure the person into undertaking any treatment he/she feels uncomfortable with.
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