Self-Harm Awareness: A Guide to Support

Self-harm is more common than many people realise, and it can affect people of all ages and backgrounds. Whether you are struggling yourself or are worried about someone you care about, it is important to know that support is available and that you do not have to face this alone.

This guide has been put together to mark Self-Injury Awareness Day on 1 March. It covers how to look after yourself if you are self-harming and how to support someone else who may be struggling. We hope it is a helpful starting point, whatever your situation.

Supporting Yourself

Keeping Yourself Safe

Looking after your wounds is a small but meaningful act of self-care, even if it does not feel that way right now. It is something you can build on over time.

It can help to put together a simple first aid kit for yourself, including bandages or plasters, antiseptic wipes or spray, and medical tape. If you use a tool that can become contaminated, try to clean and disinfect it afterwards. If your wounds are not healing, are bleeding for a long time, are causing intense pain, or are changing in temperature, colour, or size, please do reach out for medical support.

Alternatives to Self-Harm

Finding an outlet: Self-harm can be a way of releasing intense emotions that feel difficult to process. Finding other ways to get that release is a meaningful step. This might include writing your thoughts and feelings in a journal, calling a helpline, expressing yourself through a creative outlet like art, or doing physical activities such as exercise or hitting soft objects like pillows. Some people find it helpful to draw on themselves or on paper in red ink, or to hold something cold, like an ice cube, against their skin.

Reducing access: If there are particular tools or methods you tend to use, try making them less accessible. This might mean moving them to another room, or asking someone you trust to hold onto them for a while.

Using distraction: The urge to self-harm can feel like a wave, intense at its peak but not permanent. You do not need to resist it forever, just for long enough for it to begin to subside, and over time this becomes easier. Try the 10-minute rule. Delay for 10 (or 5) minutes, then check in and see if you can postpone again. Use that time to distract yourself with something you enjoy.

Everyone's coping strategies and ways of helping themselves stay safe from self-harm can look different. It isn't always an easy journey and it may take trial and error to find what works for you, and that is okay too. Some days are more difficult than others, you may relapse or find moments when the urge to self-harm is stronger than usual or you're not sure how to help keep yourself safe. It's important to remember you are not alone and support is available.

Where to Find Support

Some days are harder than others and you may find moments when the urge to self-harm feels stronger or you are unsure how to keep yourself safe. You are not alone and there is support available.

• Mental Health Matters has crisis services located across England. If you access any of these you can call our 24/7 Emotional Support Helpline.
• Shout offers free, confidential text support. Text 'SHOUT' to 85258 to get started.
• Samaritans: Call 116 123 any time to talk to a trained volunteer who is there to listen.
• Calm Harm is a free app designed to help manage the urge to self-harm. It can be found at calmharm.co.uk.
• Talking Therapies: You may be able to self-refer to NHS Talking Therapies, depending on referral criteria. Search your area and 'Talking Therapies' online or speak with your GP about other support options.
• In a crisis or emergency: Call 111 and select Option 2 to speak with the Mental Health Crisis Team, or call 999 if you need immediate emergency help.

Supporting Someone Else

Sometimes the most important thing you can do for someone is simply to be there. Starting a conversation about self-harm can feel daunting, for you and for them, but knowing what to look out for and how to approach it can make a real difference.

Signs to Look Out For

Distraction and withdrawal: Someone struggling with self-harm may seem distracted or lost in thought and may become preoccupied with certain parts of their body, such as their forearms or legs. They may also begin to withdraw from the people around them. When someone is feeling low or ashamed, pulling back is a natural response, and it is not a reflection on you or them.

Changes in mood: Self-harm is a coping mechanism, and it can affect how someone presents emotionally. They may express more negative emotions, such as sadness or anger, appear very tired, become upset more easily, or show strong resistance to expressing emotion at all, preferring to do so in private.

Covering up: Self-harm can leave physical marks. Someone who is struggling may start wearing more layers than usual, such as long sleeves or thick tights, or avoid situations where they would need to wear more revealing clothing, like shorts, even in warm weather.

Unexplained or a large number of  injuries: Someone who is self-harming may suddenly have more cuts, burns, bruises, or other injuries than would normally be expected. These may be concentrated on the opposite side of the body to their dominant hand. For example, if they are right-handed, injuries may appear on the left arm or the left side of their body. Bruising may also appear in areas that are usually well cushioned and do not bruise easily, such as the stomach.

How to Talk to Someone

Starting a conversation with someone about self-harm can be a terrifying experience, for them and for you. Being open and honest is a good step one, letting them know that you care and want to support them.

Be direct: While it can feel uncomfortable, using direct language such as "self-harm" or "cutting" is important. It encourages honesty, helps to reduce stigma, and opens the door to a more open conversation. Your ease with these words can signal a lack of judgement, which may help the other person feel safer.

Show empathy, not judgement: Self-harm often brings with it intense feelings of shame. It helps to remember that self-harm is a coping mechanism. Behind the self-injury are feelings the person is struggling to process, emotions that feel overwhelming and need an outlet. Ask them how they feel just before they self-harm, and what feelings self-harming gives them.

Check in on their physical safety: Stopping self-harm is a difficult journey, and setbacks can happen along the way. It is worth checking whether their injuries need medical attention. Things to consider include whether wounds are bleeding heavily, exposing deeper layers of skin, affecting movement, taking a long time to heal, or showing signs of infection. Where possible, encourage them to clean their wounds afterwards, using antiseptic, bandages, and to avoid intentionally re-opening or aggravating them.

Help them access support: If you or someone you care about is struggling with self-harm, support is available. Reaching out can feel hard, but it is a positive step. Mental Health Matters' Helpline offers 24/7 emotional support for anyone using our crisis services. Our teams can help you create a safety plan, explore coping strategies, or talk things through. If we do not run a service in your area, Hub of Hope by Chasing the Stigma can help you find local support. If you are worried about someone's immediate safety, call 111 and select Option 2 for your local mental health service, or call 999 in an emergency.

If you found this helpful, please do share it with anyone you think might benefit. There is no wrong time to reach out for support, and the services listed in this guide are there for you whenever you need them. You do not have to be in crisis to ask for help.

This guide was written by Lauren Johnson, Helpline Shift Supervisor, drawing on her experience supporting people through our services.