Page 4 - Guidance on how Primary Care can help :: Portus

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Top Ten Tips

01 Be aware many cases of self- 04 Understand Why, and
harm are hidden consider Underlying Issues

People often try to keep self-harm a secret because People self-harm for many reasons, and someone
of shame or fear of discovery. If you are concerned who self-harms repeatedly may not always do so for
that someone has self-harmed, for example by the same reason each time, or by the same method.
observing unusual behaviour or mannerisms,
through history or upon examination, sensitively Self-harm can effectively help people cope with
distress in the short term. But it often plays out in a
enquire and follow up where needed.
habitual need to continue the behaviour. Familiarise
yourself with the Self-harm Cycle.
02 Consider Risk Factors for It is important to spend time exploring and

Self-Harm addressing these underlying problems and the
function the self-harm fulfils. Only then can we
• Girls and young women are more likely to harm make any progress in supporting someone to
themselves than boys and young men stop self-harming.
• Boys and young men are more likely to die by
suicide

• Suicide rates increase in older adolescence
• Experiencing low income and poverty
• Experiencing gender dysphoria, or identifying as
LGBTQ+
• Experience of bereavement

• Experience of past physical or sexual abuse
• Family history/experience of mental illness,
substance misuse or suicide, low self-esteem or
hopelessness
• Evidence of neurodivergence

03 Recognise different types of

Self-harm 05 Risk Assess for Suicide
Always ask about suicide: ‘have you had thoughts of
• Self-poisoning – own or others over the counter ending your life?’ There is no evidence that asking
or prescription medication, drinking harmful increases risk. Conversely, talking about suicide may
chemicals well reduce the risk of suicide and help to reduce

• Self-injury – hitting, cutting, burning, pulling hair, the stigma associated with suicidal feelings. Always
scratching, squeezing, punching walls, swallowing remember to document thoroughly.
objects other than food and drink The self-harm and suicide prevention pathway has
• Risk taking behaviours – drug and alcohol use, the following documents to help you understand
risky sexual behaviour, absconding levels of need and risk.
• Some self-harm in boys can manifest differently • Categories of Need and Pathway
eg: getting into fights, deliberate injury in sports • Risks and Strengths Assessment

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