We spoke directly with people in England who self-harm and found out they are being let down by available support.
Our report, Pushed from pillar to post: Improving the availability and quality of support after self-harm in England, shows that there is no consistently effective support available to people who self-harm. This situation must improve to better support people and tackle rising rates of self-harm.
In 2019, people discussed self-harm in calls with Samaritans 272,000 times. That’s once every two minutes. To better understand the support available to people who self-harm, we surveyed over 500 people with lived experience and interviewed 17 of them. This research explored the whole spectrum of support experiences, from self-care through to NHS mental health services.
What did we find?
Almost everyone we spoke to had sought help in some form, whether through their GP, family and friends, self-care, mental health services, or community and voluntary groups.
However, no support type is consistently providing effective care for people who self-harm. Many described the unreasonable difficulties they’d faced trying to access support, particularly from mental health services, and a dearth of voluntary sector support for self-harm.
[A mental health nurse] said she would refer me to therapy, like CBT, again… She said, 'I don't think they'll accept you because your risk level is too high with your self-harm'.
While other support types were more accessible, they still lacked self-harm specific care and did not consistently meet the needs of those we spoke to.
Having found the courage to seek help, despite prevalent stigma and shame around the behaviour, people who self-harm are being let down.
Our research identified 4 key support needs for people who self-harm, which are essential to providing effective care:
- Distraction from immediate self-harm urges.
- Emotional relief in times of stress.
- Developing alternative coping strategies.
- Addressing the underlying reasons for self-harm.
To meet each of these needs, a holistic approach to care is required – no one support type can effectively address each of these four support needs.
The whole spectrum of support, from self-care to healthcare, urgently needs improvement to ensure the availability and suitability of help for everyone who needs it.
Samaritans report, 'Pushed from pillar to post'
The report makes a number of recommendations of how the needs of people who self-harm can be met more effectively:
- Government should ensure that planned investment in mental health support through the Long Term Plan results in specialist mental health services such as IAPT being supported with additional resource to increase expertise and capacity to support people who self-harm.
- NHS England should work with third sector experts and people with lived experience to develop a free self-care app for anyone who has presented to clinical services having self-harmed.
- GPs should be given more training to support them to deal with people who have self-harmed in a trauma informed way as well as being better informed about the types of care that can be effective in supporting people who self-harm.
- DHSC and DCMS should provide voluntary and community-based organisations with funding so they can provide a more consistent alternative to NHS support for people who self-harm.
Other research and useful links
Pushed from pillar to post complements Samaritans’ recent work with the All-Party Parliamentary Group on Suicide and Self-Harm Prevention’s inquiry, which explored young people’s experiences of mental health services.
Pushed from pillar to post focuses on support for people who self-harm in England. To see our report on support for people who self-harm in the Republic of Ireland and Northern Ireland, please use the link below:
To find out more about Pushed from pillar to post's research methodology, please see the report's methodological appendix here:
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