Fiducia TogetherSelf-harm
Hurting yourself to manage unbearable feelings. Usually not an attempt to die, and always a reason to take seriously.
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.
What it is
Self-harm is one of the most misunderstood behaviours in health care, and the misunderstanding shapes how people get treated at their most vulnerable.
Most self-harm is not a suicide attempt. It is a way of coping: relieving unbearable emotional pain, feeling something when numb, expressing what cannot be said, or regaining a sense of control. Understanding that changes the response from "why would you do that" to "what is this doing for you".
But it is not harmless, and it is not attention-seeking. Self-harm is one of the strongest predictors of later suicide, which is why every episode deserves a proper response.
Rates in young people have risen substantially over the last two decades.
Signs you might notice
Unexplained cuts, burns, bruises or scratches, often on arms, thighs or stomach.
Long sleeves in hot weather. Avoiding changing rooms and swimming.
Blades, lighters or first aid supplies kept privately.
Withdrawal, secrecy, and a marked change in mood.
Other forms: hitting, scratching, hair pulling, deliberate overdosing, and putting oneself in danger.
How it can affect day-to-day life
The NICE guideline is explicit that people who self-harm should be treated with the same care, respect and privacy as anyone else, and that this frequently does not happen. Wound care without anaesthetic, and dismissive language, are still reported.
Removing the means without replacing the function is where families go wrong most often. If self-harm is the only thing regulating unbearable feeling, taking it away without offering anything else leaves the person with nothing.
Shame drives concealment, which drives risk. A calm response is a safety measure.
Supporting someone well
Stay calm and do not react with horror or anger, however frightened you feel. Your reaction determines whether they tell you next time.
Ask what it does for them. That is the question that opens the conversation.
Treat the wound properly and without judgement, and get medical help for anything deep, bleeding heavily, or any overdose. Paracetamol overdose is a medical emergency even when the person feels fine.
Work on alternatives together rather than imposing them, and expect setbacks.
Do not make promises of secrecy you cannot keep, and say so up front.
Ask directly about suicide. It is a separate question and it needs asking.
Fiducia Life has a Calm Room and a feelings record, which gives somebody a rehearsed alternative in the moment and, over weeks, evidence that the urges are becoming manageable.
Where to get help
A GP can refer to mental health services. For under-18s, ask for CAMHS.
Samaritans are free on 116 123, any time. Papyrus HOPELINE247 is for under-35s on 0800 068 4141. Shout offers text support: text SHOUT to 85258.
Go to A and E for any serious injury or any overdose.
Tools we make that might help
These are our own products. We have put them here because they do something specific for this condition, not because every page needs a list.
Fiducia Life
A Calm Room to rehearse, and a record that shows urges becoming manageable.
Last reviewed 2026-08-28 by Fiducia Together · Next review due 2027-08-28
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.