Self-harm/Self injury

Self-harm is a way of dealing with very difficult feelings that build up inside the child or young person and which they find hard to express or deal with in any other way.  It can take a number of forms but most commonly presents as cutting or burning, bruising, taking an overdose of tablets, hair pulling or picking skin.

Initial intervention from other Tier 1/2 services (Universal and Targeted services) prior to specialist CAMHS involvement 

Most school counsellors provide support for children and young people who self harm as a way of coping with strong emotions and difficult experiences, where the self harm is mild to moderate, there is limited risk, and no underlying mental health difficulty (ie. depression).  Training is provided to tier 2 professionals by Papyrus and MIND.

Self help literature: 

NHS Self Help Guides Royal College of Psychiatrists Young Minds

Mindful online counselling

NHS Inform

Support and intervention from pastoral support/ School counsellor or mental health support team where one is available.

Involvement of an Educational Psychologist. Mild symptoms – monitoring by universal Tier 1/2 professionals.

Service provided by Specialist Child and Adolescent Mental Health Service –   Tier 3

Where depression persists and does not respond to interventions at tier 2, or where symptoms are such that the impact on everyday life is severe or where there are concerns about extent of self harm or suicidal thinking persists then refer to specialist CAMHS.

May be offered Cognitive Behavioural Therapy (CBT) / behavioural/ solution
Focussed based intervention/ Systemic family practice/ psychodynamic psychotherapy/ interpersonal psychotherapy Medication although not a first line treatment may be initiated by a Consultant Child Psychiatrist, in consultation with young person, their family and other Specialist CAMHS practitioners who may be working with the young person. The GP will be informed.