Keep the conversation open
- Choose a private moment without an immediate deadline.
- Ask one open question, then allow pauses.
- Listen for feelings and circumstances, not method details.
- Ask what support would feel useful.
- Be honest if you need advice or cannot safely keep something secret.[1]
What to avoid saying
- “Promise me you will stop.” Mind advises avoiding pressure and letting the person retain control of decisions.
- “You're doing it for attention.” The NHS specifically advises against insulting or attention-seeking labels.
- “How could you do this to us?” This shifts the conversation towards guilt and away from what they are experiencing.
- “You're a self-harmer.” Mind advises against turning a behaviour into the person's identity.
- “Show me.” Ask whether medical help is needed rather than demanding to inspect their body.
If they do not want to talk about it
They may not be ready to explain their self-harm, especially if they are worried about how you will react. You do not need to make them tell you what happened. Avoid repeated questions, checking their body or demanding a promise to stop. Let them know that you care and keep ordinary contact going, including time together when self-harm is not the subject.[2]
“You don't have to explain it to me. I'm worried about you and want you to be safe. We can leave the conversation for now, but I'm here, or I can help you talk to someone else.”
They might find it easier to send a message, write something down or speak privately to a GP, counsellor or another person they trust. Offer these choices without pressing for an answer. A quiet visit or an ordinary conversation may be more welcome than another discussion about how they are feeling. Professional support for self-harm explains what help is available.
What if they do not want help either?
An adult who has capacity to decide about treatment can generally refuse an ordinary assessment or treatment. But you can still ask for advice and tell their GP or existing mental-health team what you have observed, even if they do not want you involved in their care. Services may not be able to discuss their treatment with you. NICE explicitly says that family members and carers can provide information without the person's agreement to involving them. Where it is safe and appropriate, be open with them about why you are contacting someone.[3]
If there might be an injury needing medical treatment, get medical advice using the medical-help guidance. If you are worried about suicide, ask directly and use the suicide concern guide; self-harm does not necessarily mean someone wants to die. If someone's life is at immediate risk, including a suspected overdose or serious injury, call 999. You do not need their permission to seek emergency help. For other urgent concerns, use the appropriate UK urgent-help route.
Ask about suicide if you are worried
Self-harm does not always mean someone intends to die, but the NHS says there is a clear link with suicidal thoughts. If you are concerned, ask directly and use the dedicated guide.
How to ask about suicideSources and how this guide was written
Keep the conversation open
Back to the adviceIf they do not want to talk
NHS: how to help someone else and Mind: supporting someone who self-harms. Both recommend patience, everyday contact and leaving decisions with the person where possible.Back to the adviceIf they do not want help
NICE NG225, recommendations 1.2 and 1.4, on consent, sharing concerns and alternative communication. See also how consent works.Back to the advice
Last full source check: 28 August 2026
Later check: refusing to discuss self-harm and sharing concerns with professionals — 9 October 2026 (NHS, Mind and NICE). The original full-guide review date is unchanged.
Independent information, not a medical or crisis service. This guidance has not been clinically reviewed. How we use sources.
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