Self-harm – Guide for the public
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) recommends the following guideline for members of the public.
Self-harm: short-term treatment and management
Understanding NICE guidance – information for people who self-harm, their advocates and carers, and the public (including information for young people under 16 years).
This guideline, published in 2011, was produced by the UK National Institute for Clinical Excellence (NICE).
Key points for the public when using this guideline
People who have deliberately injured themselves, overdosed with medicine/s or swallowed a poisonous substance should go to an emergency department straight away. Information on what can be expected when receiving emergency treatment for people who have overdosed and are conscious can be found in the NICE guideline for the public: Emergency treatment (p. 19).
If you are a relative of a person who has overdosed and is unconscious and would like more information, please see: Advice for relatives of unconscious patients who have taken an overdose
The assessment and treatment plan
People who have self-harmed should be assessed by both a professional responsible for medical treatment and a specialist mental health professional. The assessment should include a full physical, psychological and social assessment of their needs, and information should be sought from family members and/or the person’s GP.
Following the assessment, the treating doctor should develop a management plan, which will include follow-up arrangements with an identified health-care professional. This may be a clinician or a mental health service. The management plan will be clearly communicated to the person who has self-harmed and the family.
Information on what is involved in a psychosocial assessment is available in the NICE guideline for the public: Psychological assessment for people who self harm (p. 29).
What can I expect from health professionals?
When receiving treatment it is reasonable for you (the person, carer or family member) to expect to be:
- treated with respect
- not made to feel 'judged'
- provided with the opportunity to express your feelings and concerns
- provided with information about your rights concerning confidentiality and consent
- given the choice to choose to involve your partner and/or family member/s in decisions about the treatment and follow-up plan.
Information for carers
Caring for someone who self-harms can be difficult. Further information can be found in the NICE guidelines: Information for carers of a person who self-harms (p. 51)
Specific information is also available for carers of young people under 16 years: Information for children and young people (under 16 years)
This information is provided to assist with the implementation of the NICE guideline in Australia and New Zealand.
Guideline review process
A panel of specialists reviewed a number of guidelines for the treatment of self-harm using the AGREE instrument (Appraisal of Guidelines for Research and Evaluation).
The panel of specialists comprised:
- Dr Simon Hatcher, Chair (NZ)
- Professor Gregory Carter (NSW)
- Professor Sunny Collings (NZ)
- Professor Diego de Leo (QLD)
- Professor Robert Goldney (SA)
- Professor Graham Martin (QLD)
Review of the clinical guidelines and development of this information involved comprehensive input from consumers and carers.
Approved by RANZCP General Council: 18 August 2012.
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NICE disclaimer: Clinical Guideline 16 was issued by the National Institute for Health and Clinical Excellence (NICE) in September 2008. NICE guidance is prepared for the National Health Service in England and Wales. NICE guidance does not apply to Australia and New Zealand and NICE has not been involved in the development or adaptation of any guidance for use in New Zealand and Australia.
►Interested in information for clinicians? Visit our Self-harm practice guidelines page.