We need to talk about self-harm

Mental Health

The rates of self-harm are rising, and while asking for help is often the first step to feeling better, it’s a topic we struggle to talk about. Today, Samaritans are calling on the government to prioritise support for people who self-harm

We want to talk about self-harm. We know people struggle to talk about self-harm, but asking for help or encouraging a loved one to open up can be the first step to feeling better.

The reasons someone might self-harm are complex. We know self-harm is a sign of serious emotional distress and most people who self-harm do so as a way of trying to cope with these difficult feelings. But evidence shows that self-harm doesn’t help reduce these kinds of feelings over time and can lead to suicidal thoughts developing.

It’s important to remember that most people who self-harm will not go on to take their own life, but there is a strong link between suicide and self-harm. A study of young people (16 to 21 year olds), found self-harm is one of the strongest predictors of transition from suicidal thoughts to attempts. Samaritans volunteers see this first-hand, with those discussing self-harm 2.5 times more likely to express suicidal thoughts or behaviours than other callers.

It can be hard to know what to say, but just letting them know you care and that they don’t need to apologise can help.

The rates of self-harm are rising. The latest data in England (from 2014), shows that 6.3% of adults have self-harmed at some point in their lives, which is more than double since 2000. There have been increases in both men and women, of all ages, but by far the biggest increase is among young women (16-24). In total, one in four young women have self-harmed at some point. It’s likely some of the increase is due to reduced stigma, meaning people may be more willing to report self-harm. Even so, this is very unlikely to account for all of the rise.

We want people to learn healthy coping strategies that they can use throughout their lives. If self-harm becomes a long-term behaviour, it may be harder to find alternative healthier ways of coping with distress later in life. For these reasons, it is vital that effective and accessible support is offered to those who have self-harmed.

However, our research found that people who self-harm in England are often considered “too high risk” for primary mental health care such as psychological therapies through IAPT (Improving Access to Psychological Therapies), while not ill enough for secondary care services like Community Mental Health Teams. This can lead to people feeling ‘ping-ponged’ between services, struggling to get the support they need. We also found that specialist self-harm support in local communities – outside of health care settings – is patchy.

The impact of lockdown

Unfortunately, Coronavirus has made it harder still for some to access support. During the first lockdown last March, presentations to hospitals as well as GPs for self-harm dropped, especially among women.

However, some charities, including Samaritans, have seen an increase in the number of contacts about self-harm. Young people are telling us that lack of access to mental health support is a major concern, and that adjusting to online support can be challenging. This raises significant concerns about how people who self-harm are coping at this time.

Reduced contact with family and friends, plus restrictions affecting community groups, are also leaving some people who self-harm without their usual connections. We know that loneliness and self-harm are linked. Three in 10 people who self-harmed in the past year said they felt very lonely and isolated – more than 10 times higher than those who hadn’t self-harmed.

During the first nine months of restrictions, Samaritans answered 10% more contacts about loneliness compared to the same time last year. So, supporting people to stay connected during and after the restrictions is key.

That’s why, this Self-Injury Awareness Day, we’re calling on the government to prioritise support for people who self-harm. In England, that means working with the NHS to ensure no one who self-harms is excluded from getting mental health support. It also means bolstering voluntary sector support, as charities play a vital part in addressing the underlying causes of self-harm, such as loneliness.

There’s also a lot that we can do. Stigma means people can feel really apologetic and embarrassed about self-harming. We can all help reduce this stigma by offering non-judgmental support if someone we know self-harms.

It can be hard to know what to say, but just letting them know you care and that they don’t need to apologise can help. If you’re worried about someone you love, you can also read our tips on how to support someone who might be self-harming.


For anyone struggling with self-harm, seeking help is an important first step. You can start by talking to your GP, and we’d also encourage anyone who’s struggling to consider talking to a friend or family member you trust.

You can also get confidential support from Samaritans – every day our volunteers provide emotional support to people who self-harm. As well as calling our helpline on 116 123 or emailing jo@samaritans.org, you can download our self-help app.

If you’d like to speak to a professional about what you’re feeling, you can do that too. On Counselling Directory, you can browse over 15,000 therapists working online right now. When you find a therapist you resonate with, simply send them an email.



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