Self-Harm: Quick Reference Guide for Health and Care Workers

A practical guide for safe, compassionate responses

1. Pause and ground yourself

• Take a moment to stay calm before responding. 
• Your steady presence helps patients feel safe. 
• Remember: you are not responsible for their self-harm. 

2. Responding to disclosures

Do: 

• Listen actively and without judgement. 
• Thank them for telling you; acknowledge the courage it takes.
• Use the patient’s own language where possible.
• Explain clearly what information may need to be shared and why.

Avoid: 

• Minimising injuries (“It’s just a scratch”).
• Judging (“You’re doing it for attention”).
• Pressuring to stop self-harming immediately.
• Forcing disclosure or asking to see injuries unless clinically necessary.

3. Supporting ongoing care

• Explore reasons for self-harm only if patient is ready. 
• Support small steps toward safety: 
  • Cleaning or safely managing implements.
  • Caring for injuries.
  • Reducing frequency/severity gradually. 
  • Offer alternative ways to express distress if open (writing, drawing, physical activity).
  • Recognise progress may be gradual; stopping self-harm is not always the immediate goal.

4. Supporting yourself

• Notice your own stress and emotional responses.
• Use grounding or calming techniques. 
• Seek supervision or peer support after difficult encounters. 
• Self-care is essential to provide safe, effective care.

Key Principles: 

• Respond with calm, compassion, and non-judgement.
• Safety first: assess and manage urgent risk.
• Language matters: validate the person’s experience.
• Respect pace: trust and progress take time.
• Take care of yourself while caring for others.