Self-Harm and Suicide Prevention

Self-harm and suicide are critical public health issues, particularly among individuals experiencing acute mental health crises. Both behaviours are complex and multifaceted, often rooted in deep emotional pain, trauma, or mental health disorders. Addressing these concerns requires a compassionate, evidence-based approach focused on early intervention, comprehensive treatment, and ongoing support. At our hospital, we are committed to providing specialised care to individuals struggling with self-harm and suicidal ideation, promoting recovery, resilience, and hope.

Man with depression

Understanding Self-Harm

Self-harm, also known as self-injury, is the act of deliberately injuring oneself, typically as a way to cope with overwhelming emotions or psychological distress. Contrary to some misconceptions, self-harm is not necessarily a direct attempt to end one’s life, but it can increase the risk of suicide if left unaddressed. The behaviours associated with self-harm can vary, ranging from cutting, burning, or hitting oneself to engaging in reckless behaviours that endanger personal safety.

Why People Self-Harm

People who self-harm often describe it as a way to release intense emotions, numb psychological pain, or regain a sense of control. It can be a response to feelings of shame, guilt, anger, sadness, or hopelessness. Common reasons for self-harm include:

  • Emotional release: Physical pain can serve as a temporary distraction from emotional turmoil or numbness.

  • Control: For individuals feeling powerless in other aspects of their life, self-harm may provide a sense of control over their body.

  • Self-punishment: Some people engage in self-harm as a way to punish themselves, often due to feelings of worthlessness or guilt.

  • Communication: While not always the case, some individuals may use self-harm as a way to express distress or ask for help when they feel unable to articulate their emotions verbally.

Although self-harm can provide a temporary sense of relief, it is not a healthy or sustainable coping mechanism. Over time, it can exacerbate feelings of isolation, shame, and hopelessness, making recovery even more challenging.

Risk Factors for Self-Harm

While self-harm can affect individuals of any age, gender, or background, certain factors may increase the likelihood of engaging in this behaviour. These include:

Mental health disorders

Depression, anxiety, borderline personality disorder, post-traumatic stress disorder (PTSD), and eating disorders are all associated with higher rates of self-harm.

Trauma or abuse

A history of physical, emotional, or sexual abuse, particularly in childhood, is a significant risk factor for self-harm.

Substance misuse

Alcohol and drug use can impair judgment, reduce inhibitions, and increase the likelihood of self-harming behaviours.

Low self-esteem

Individuals with a negative self-image or feelings of worthlessness may be more prone to self-harm as a form of self-punishment.

Social isolation

A lack of supportive relationships, bullying, or social rejection can contribute to feelings of loneliness and despair, leading to self-harm.

Life stressors

Major life events, such as relationship breakdowns, financial difficulties, or the loss of a loved one, can trigger self-harming behaviours.

Recognising these risk factors is crucial in identifying individuals who may be at higher risk of self-harm, allowing for early intervention and support.

Suicide Prevention

Suicidal thoughts, also known as suicidal ideation, are more common than many people realise. These thoughts can range from fleeting considerations of suicide to detailed planning and intent. While not everyone who experiences suicidal ideation will attempt suicide, it is a serious warning sign that should never be ignored.

Warning Signs of Suicidal Thoughts

It is essential to be aware of the warning signs of suicide, particularly in individuals with a history of self-harm or mental health disorders. These signs may include:

  • Talking about death or suicide: This can include direct statements, such as “I wish I were dead,” or more subtle comments, such as “Everyone would be better off without me.”

  • Expressing hopelessness: A sense of despair or belief that there is no way out of their pain can indicate suicidal thoughts.

  • Withdrawing from others: Social isolation, losing interest in activities or hobbies, or withdrawing from family and friends can signal emotional distress.

  • Sudden changes in mood: While depression is often linked to suicide, a sudden improvement in mood after a period of intense sadness can be a red flag, as it may indicate that the person has made a decision to act on suicidal thoughts.

  • Engaging in risky behaviours: Reckless actions, such as driving dangerously, substance misuse, or other risky activities, may indicate a disregard for personal safety.

  • Giving away possessions: If someone begins to give away valued belongings or settle affairs, it could indicate that they are preparing for the possibility of suicide.

Woman with depression

Risk Factors for Suicide

As with self-harm, certain risk factors can increase the likelihood of suicide. These include:

  • Mental illness: Depression, bipolar disorder, schizophrenia, borderline personality disorder, and PTSD are all associated with an increased risk of suicide.

  • Previous suicide attempts: Individuals who have attempted suicide in the past are at a higher risk of attempting again in the future.

  • Family history of suicide: A family history of suicide can increase the risk, possibly due to genetic factors or the emotional impact of losing a loved one in this way.

  • Substance misuse: Alcohol and drug use can impair judgment and increase impulsivity, making it more likely that an individual will act on suicidal thoughts.

  • Trauma and abuse: A history of trauma, particularly childhood abuse, is strongly associated with an increased risk of suicide.

  • Chronic physical illness: Chronic pain, terminal illness, or disability can contribute to feelings of hopelessness and suicidal ideation.

  • Life stressors: Major life events, such as the loss of a loved one, financial difficulties, or relationship problems, can trigger suicidal thoughts.

Prevention Strategies: Early Intervention and Support

Preventing self-harm and suicide requires a comprehensive approach that addresses both the immediate needs of individuals in crisis and the underlying causes of their distress. Our approach is guided by evidence-based strategies designed to provide immediate support, encourage long-term recovery, and reduce the risk of relapse.

Creating a Safe Environment

A critical aspect of suicide prevention is ensuring that the environment is as safe as possible for individuals who are at risk. This includes removing access to means of self-harm or suicide, such as sharp objects, medications, or other potentially dangerous items. Creating a supportive, non-judgmental space where individuals feel heard and understood can also significantly reduce the risk of harm.

Providing Immediate Support

For individuals in acute crisis, immediate support is essential. This may involve crisis intervention, such as suicide risk assessments and the development of safety plans. Safety plans typically include identifying triggers for suicidal thoughts, developing coping strategies, and creating a list of supportive contacts to reach out to in times of distress.

Therapeutic Interventions

We believe in offering a range of therapeutic interventions tailored to the individual’s needs. These may include:

  • Cognitive Behavioural Therapy (CBT): CBT helps individuals identify and challenge negative thought patterns that contribute to self-harm and suicidal ideation. It encourages the development of healthier coping mechanisms and problem-solving skills.

  • Dialectical Behavioural Therapy (DBT): DBT is particularly effective for individuals with borderline personality disorder, a condition commonly associated with self-harm. It focuses on teaching skills related to emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness.

  • Psychotherapy: Talking therapies can help individuals explore the underlying causes of their distress, whether it is rooted in trauma, abuse, or long-standing emotional pain.

  • Family Therapy: Involving family members in the therapeutic process can provide additional support and help loved ones better understand the challenges faced by the individual.

Building Resilience and Coping Skills

Long-term recovery from self-harm and suicidal ideation requires the development of resilience and healthy coping mechanisms. We work closely with individuals to help them build a toolkit of skills that can be used in times of distress. These may include mindfulness exercises, relaxation techniques, and strategies for managing emotions in a constructive way.

  • In some cases, medication may be necessary to help manage underlying mental health conditions, such as depression, anxiety, or bipolar disorder. Antidepressants, mood stabilisers, and antipsychotic medications can play a key role in stabilising mood and reducing the intensity of suicidal thoughts. Medication is always prescribed and monitored in conjunction with other therapeutic interventions to ensure a holistic approach to treatment.

  • Social isolation is a significant risk factor for both self-harm and suicide. Encouraging individuals to reconnect with loved ones, build supportive relationships, and engage in meaningful activities can be a powerful protective factor. Our staff help individuals identify and nurture supportive connections, whether through family, friends, or peer support groups.

  • Empowering individuals to take an active role in their recovery is central to our approach. By promoting self-management and encouraging individuals to recognise their strengths, we help them develop a sense of agency and control over their mental health. This can reduce the likelihood of relapse and increase resilience in the face of future challenges.

  • We recognise that self-harm and suicidal ideation are often symptoms of deeper emotional pain and mental health conditions. Therefore, our care is holistic, addressing not only the mental health aspects but also physical, emotional, and social well-being. Our multidisciplinary team includes psychiatrists, psychologists, nurses, and support staff who work together to provide personalised, compassionate care.

  • Successful suicide prevention extends beyond the inpatient setting. As part of our commitment to long-term recovery, we work closely with community mental health teams to ensure a seamless transition from hospital to home. By coordinating care with external services, we aim to reduce the risk of relapse and promote continuity of care.

  • A significant number of individuals who self-harm or experience suicidal thoughts have a history of trauma. Our approach is trauma-informed, meaning that we recognise the impact of past trauma on current behaviour and work to create a safe, supportive environment. This includes fostering a sense of trust and collaboration, avoiding re-traumatisation, and empowering individuals to take an active role in their treatment.

The Importance of Compassion and Empathy

One of the most important elements of suicide prevention is compassion. Individuals who self-harm or experience suicidal thoughts often feel misunderstood, ashamed, or alone. Providing non-judgmental support and showing empathy can be life-changing, offering hope to those who may feel that their situation is hopeless.

Self-harm and suicide are deeply complex issues that require a multifaceted approach. By focusing on early intervention, compassionate care, and evidence-based treatment, we aim to reduce the incidence of these behaviours and support individuals on their journey towards recovery. Through therapeutic interventions, social support, and the promotion of resilience, we are committed to helping individuals build healthier, more fulfilling lives free from the pain of self-harm and suicidal ideation.

Our work doesn’t end at the hospital doors. By collaborating with community services and empowering individuals to take control of their mental health, we strive to create lasting change, helping people not only survive but thrive. Together, we can make a difference, one life at a time.