Getting help for self-harm

Offer practical help with booking, travel or taking notes. Agree whether they want you in the room, there for part of the appointment, or outside.

Prepare a short account of what has changed, how distress affects daily life, existing support and what they want help with. Include any concern about suicide. You do not need graphic descriptions or a complete history before asking for help.

A mental-health assessment can lead to a treatment plan, including talking therapy. Ask what support is available for the distress behind the self-harm, who will arrange it and what happens while they wait.^[1]

Treatment of an injury and assessment of the person's mental-health needs are different parts of care. Ask whether a mental-health professional has spoken with them about what led to the self-harm, their circumstances and the support they need.

Before leaving, write down:

• The team responsible for the next contact, and how to reach it.
• When that contact is expected and whether it is booked.
• What to do if distress increases before then.
• Any part of the plan that depends on you, and whether you can provide it.

NICE recommends initial aftercare within 48 hours of the psychosocial assessment if there are ongoing safety concerns. This is a recommendation about follow-up, not a reason to wait 48 hours for urgent help.^[2]

If they are still at hospital: ask the nurse or doctor who is arranging the mental-health assessment and discharge plan. Say what is unresolved and tell them if the proposed support at home is not available.

If they have left: use the contact on the discharge letter. If there is no useful contact, call the hospital department they attended or their GP and explain that follow-up is unclear. Ask who is responsible for the next step.

Record who you spoke to and what they agreed. If a promised call does not come, contact that team again and say it was missed. If they are in danger or need medical help now, use the urgent route while the missing follow-up is being resolved.

Services differ across the UK. Ask the local team to explain its arrangements rather than assuming a referral has reached the right place.

Ask for the reason, what is offered instead and what would prompt another assessment. NICE says a risk score or a label such as “low risk” should not decide who receives treatment.

Write down the unanswered need: an assessment, treatment, follow-up or help at home. The services-say-no guide explains how to request reconsideration and use the relevant complaint route.

If the person declines help, you can still offer a return conversation and practical help with an appointment. For recurrence, ask for a review of the whole plan.^[3]