Self-Harm

Getting Help for Self-Harm

Self-harm means intentionally injuring or poisoning yourself. Care should address your immediate safety and the difficulties behind the behavior.^[1]

Call 911 for a life-threatening injury or immediate danger. If someone collapses, has a seizure, struggles to breathe or cannot be awakened after a possible poisoning, call 911 immediately.^[2]

After an intentional overdose or possible poisoning, get medical advice immediately by calling Poison Control at 1-800-222-1222. Its automated online tool is not intended for self-harm. Speak with a poison specialist instead of trying to judge the danger yourself.^[3]

For suicidal thoughts or emotional distress in the United States, call or text 988, or use 988 Lifeline chat. You can contact the service about yourself or someone else. A crisis conversation does not replace emergency medical care for an injury.^[4]

Why Self-Harm Can Be Hard to Stop

For some people, self-injury briefly eases overwhelming feelings. For others, it is a response to numbness, loneliness or self-directed anger. When painful feelings return, the urge may return too. These experiences help explain the behavior without making it safe.^[5]

Self-harm and a suicide attempt are not interchangeable. A person may injure themselves without wanting to die. However, self-injury is associated with greater suicide risk and can cause unintended serious harm. Do not assume that someone is safe simply because they describe the behavior as coping.^[5]

Self-harm can occur alongside different mental health conditions, including depression, anxiety and trauma-related difficulties. It can affect adults as well as young people. An assessment helps clarify what is happening for that individual.^[5]

Getting Through an Urge to Self-Harm

If you are not in immediate danger, try creating a little space between the urge and acting on it. The NHS suggests harmless distractions, talking to someone, writing about feelings and calming breathing. These are options to try, not a test you must pass before asking for help.^[7]

• Make contact. Ask a trusted person to talk with you. If words are difficult, send a short message asking for company or support.^[7]
• Choose something gentle to focus on. Listen to familiar music, write a few sentences about what you feel or try a calming breathing exercise.^[7]
• Use your existing safety plan. Follow the coping steps and contact list you developed with your care team. If those steps are not enough, reach the next source of help.^[1]

If the urge continues or you are unsure how to stay safe, contact 988 for support. Use 911 for immediate danger. Do not keep trying a distraction instead of seeking urgent care.^[4]

Telling Someone About Self-Harm

You can start with a trusted person who can help you reach professional support. In Harvard Health, psychologist Matthew Nock emphasizes listening without judgment when someone discloses self-injury. For a parent, that means making room to hear what is happening before reacting with anger or panic.^[8]

Here are optional words to adapt. These are conversation examples, not statements from real patients.

• To a friend: “I’m struggling with urges to hurt myself. Could you stay with me while I ask for help?”
• To a clinician: “I’ve been hurting myself, and I need help with both the injuries and what leads up to them.”
• To a trusted adult: “I need to tell you something difficult. Please listen first, then help me work out what to do.”

If a young person tells you a friend is self-harming, help them involve a trusted adult. Nock advises parents against promising secrecy when a child’s life is at risk. The aim is to bring in help while continuing to listen.^[8]

What Happens During a Self-Harm Assessment?

A psychosocial assessment is a conversation about your feelings, daily life, relationships, support and safety. It is not just an inspection of an injury. The clinician may ask what happened before and after the self-harm, what you hoped it would change and what has helped you cope before.^[9]

Expect questions about thoughts of suicide, medicines, alcohol or drug use and other health concerns. You can ask why a question matters or say when you need a pause. The information helps the clinician work with you on a care plan.^[9]

NICE, England’s health guidance organization, advises against using a low, medium or high risk label to decide who receives care after self-harm. Your needs and circumstances matter.^[1]

Treatment for Self-Harm

Treatment can help you understand the urges and practice different ways to handle distress. Cognitive behavioral therapy, or CBT, works on connections among thoughts, feelings and actions. Dialectical behavior therapy, or DBT, teaches skills for managing strong emotions, coping with distress and communicating with other people.^[6]

The right approach depends on the person’s age and needs. NICE recommends a structured CBT-informed intervention tailored to adults who self-harm. It advises considering DBT adapted for adolescents who frequently self-harm and have substantial difficulty managing emotions. That is a specific recommendation, not a claim that one therapy is best for everyone.^[1]

You can explore what DBT and its skills involve, then ask a clinician how the approach would fit your situation. A skills explanation is not a substitute for assessment or urgent support.

There is no medicine specifically for self-injuring behavior. A clinician may recommend medicine for a related condition, such as depression. Some people need hospital or day-program care when safety requires more intensive support.^[6]

Making a Safety Plan with Your Care Team

A safety plan is a written set of steps for a difficult moment. NICE recommends identifying warning signs, coping activities, supportive people, professional contacts and ways to make the environment safer. Work with a counselor on limiting access to things you might use to hurt yourself.^[1]

Ask your clinician to make the plan specific enough to use: Who answers after hours? What happens if the first contact is unavailable? Where will you keep the plan? A list of names is more useful when you know how and when to reach each person.

Finding a Self-Harm Therapist Near You or Online

Start by asking your primary care clinician for a referral, or contact a mental health professional with experience treating self-injury. A familiar person can accompany you if you want support at an appointment.^[6]

For a local search, try “self-harm therapist” plus your city or ZIP code. Use the results to make a shortlist, then ask direct questions. A listing by itself does not tell you whether the clinician can offer the support you need.

• Experience. “Do you treat people my age who self-harm? What would assessment and treatment look like?”
• Between-session help. “Who should I contact if urges increase before our next appointment?”
• Practical access. “Are you accepting new patients? What are the fees, insurance options and waiting times?”
• Online suitability. “Can you provide care where I live? Is video care appropriate for me, and how would urgent help work?”
• Privacy. “What can remain private, and when might you need to share information to protect someone’s safety?”

Some talking therapies can be offered by video or telephone. Ask about that option if travel is difficult, while making clear whether you need injury care or urgent support. Agree on a care plan rather than assuming the appointment format alone meets your needs.^[9]

Helping Someone Who Self-Harms

Listen first, then offer a concrete next step. In a Cornell Chronicle interview, self-injury researcher Janis Whitlock describes the importance of parents being present and listening instead of immediately trying to fix everything. She also encourages parents to seek support for their own difficult feelings.^[10]

For example: “Thank you for telling me. I want to understand, and I want to help you get care. Would you like me to sit with you while you call?” If you are frightened or upset, find someone else to support you rather than making the person manage your reaction.^[10]

If you are worried about suicide, ask directly: “Are you thinking about suicide?” The National Institute of Mental Health explains that asking does not increase suicidal thoughts or behavior. Listen without judgment, help the person connect with support and stay in contact afterward.^[11]

Offer a manageable form of help, such as arranging transport or attending an appointment if invited. You can also explore support for families navigating mental illness. Supporting someone does not require having every answer.

Taking the Next Step Toward Support

You can begin by telling one person what is happening or asking a clinician for an assessment. For ongoing care, explore therapy and treatment options and ask about specific experience with self-harm. Use the questions above to make that conversation concrete.

If you need crisis support now, call or text 988 in the United States. For immediate danger or a life-threatening injury, call 911.^[4]