First aid for self-harm resource

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This resource contains information which may be useful for performing care or advocacy work, or describes overall policy and principles.

This protocol is a draft. It has not yet been accepted as protocol and may be incorrect or poorly cited. Please do not use this in your work until it has been accepted.

Please see #protocols on Slack to discuss this protocol further.

This document needs review by medical professionals before it is adopted. If you are a medical professional, please use this form to provide feedback

More documents in need of medical review can be found here.

This is a resource for people who are self-harming, or people who are supporting someone who self-harms. It covers some basic first aid tips which may be relevant to common forms of self-injury. You may also want to see our 'Safer self-harm resource' for information about how to reduce the risk of serious injury.

This is not a substitute for first aid training and does not qualify anyone to describe themself as a ‘first aider’.

These guides set out signs that an injury may present an urgent/potentially life-threatening risk, requiring an ambulance. They also covers situations where the injury is likely to deteriorate and risk further damage unless you go to A & E or seek other urgent medical treatment. You can still call an ambulance in these scenarios if you don’t feel well enough to travel to hospital.

We recognise that many people may be concerned about the potential consequences of going to hospital after self-harming. This resource is intended to help you assess when the risks of not getting medical help may outweigh the risks of doing so.

If you are supporting another person to treat their injuries, it’s also important to remember the risks of disease transmission, and wear gloves while handling any bodily fluids.

First aid guides

See the following pages for more information about how to treat each kind of injury:

Going to A & E

If you’re concerned about how you may be treated at the hospital, you could take some steps to prepare for this and mitigate the risks.

  • If you know you are likely to self-harm in ways that will require medical treatment, and think you may have difficulty communicating your wishes at the time, you could write an advance directive covering issues such as
    • What forms of treatment you do/don’t consent to
    • Who you do/don’t want to be present
    • Whether you only want physical treatment or whether you want a ‘needs assessment’
    • Any particular environmental needs you have
  • If you might have difficulty speaking when you arrive at hospital, you can also download cards with tick-boxes to indicate the nature and location of the injury.
  • In addition to physical treatment, the hospital should offer you a ‘psychosocial needs assessment’ to see what followup support is required. However, the NICE Guidance on self-harm states that this should not be compulsory:
    • ‘People who have self-harmed should be offered treatment for the physical consequences of self-harm, regardless of their willingness to accept psychosocial assessment or psychiatric treatment’. (NICE Guidance )
  • If you want to receive only physical treatment, they will assess whether they think you pose an ongoing risk to yourself before you leave. In order to minimise any risk of being detained against your wishes, it’s helpful to try and emphasise that you
    • Don’t want to hurt yourself any further
    • Don’t have specific methods in mind
    • Don’t have easy access to self-harm tools
    • Do have a strong support network