Mental Health services for people who self-harm in England are inadequate, say Samaritans

Ahead of World Mental Health Day on 10 October, Samaritans say the government needs to improve NHS mental health services to better support people who self-harm and tackle the rising rates of self-harm.

The leading suicide prevention charity spoke to over 500 people (aged 16+) as part of a new report, Pushed from pillar to post, and found too many people who self-harm are let down by NHS services.

A quarter (25%) of people said they sought NHS mental health support after they self-harmed but many described being excluded from services or receiving ineffective care for their self-harm. The research found that people who self-harm are caught between services – deemed too high risk to access common mental health services such as IAPT (Improving Access to Psychological Therapies), the government’s flagship programme for treating common mental health disorders, while regarded as not ill enough to access community mental health teams. As a result, people felt ‘ping-ponged’ between services, struggling to access appropriate care.

For those who did access NHS services, too often self-harm was ignored or even banned as a topic. As a result, people weren’t able to develop the coping mechanisms they needed or address the underlying reasons for their self-harm.

Samaritans Assistant Director of Research and Influencing, Jacqui Morrissey, said: “Self-harm is a strong risk factor for suicide – however, the majority of people who self-harm do so without wanting to end their life and as a way of trying to cope with distressing feelings. What our research shows is that people in serious emotional distress who self-harm are slipping through the cracks in NHS support. Having found the courage to reach out for help, this vulnerable group are being denied support because the current system is not set up to help them. Mental health services such as IAPT need to be able to support people who self-harm. Planned government investment in mental health services should prioritise increasing capacity and expertise that ensures targeted support for people who have self-harmed. Exclusion criteria around self-harm should be removed and this support should be available to anyone who needs it.

“Crucially, we need this investment much sooner than is currently planned. This research was carried out prior to the pandemic, which we know has had a profound social and psychological impact on many people, leaving them without access to support networks and ultimately exacerbating issues. Given that demand was already outstripping capacity before Covid, we are really concerned about the system’s ability to cope in the current circumstances. Therefore, it’s vital that effective support is made available much sooner to the most vulnerable people as we continue to face the challenges of Covid.”

Having taken the daunting first step of seeking help, people with experience of self-harm are too often told their needs do not fit with the available provision. The research shows people without a long-standing mental health condition (60% of participants) were less likely to seek support from health services than those with a long-term condition and were more likely to say healthcare had not been useful for their self-harm.

Ruth, 21, found herself struggling when her older sister left for university, and at just 14 began self-harming. Once her father found out, they began to seek help but faced great difficulties in accessing the support she urgently needed.

People that the charity spoke to highlighted the helpful role of friends, peers and social support in providing emotional relief in times of stress, but they also spoke of the stigma associated with doing so.

Ruth also found talking to her friends helpful, she said: “The most useful support when I was self-harming was support from my friends who didn’t judge me, but who gradually helped me begin to stop.”

In 2019, self-harm was discussed in more than 272,000 calls for help to Samaritans volunteers. With self-harm rates more than doubling since 2000, the challenge to improve support for self-harm could not be more urgent.

Pushed from pillar to post, explores the experiences and needs of people with lived experience of self-harm and maps out how the whole range of support, from self-care to healthcare, can be improved. Samaritans has produced a new film, which was informed by people were part of the research and explores the subject of self-harm. This will be published on World Mental Health Day.

This research adds to the findings from the recent report of the All Party Parliamentary Group on Suicide and Self-Harm Prevention, which looked at the effectiveness of support for young people specifically and also found those who self-harm are struggling to get the support they urgently need.

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For more information or interview requests, please contact the Samaritans Press Team at [email protected] or 020 8394 8300.

Notes to editors

• The online survey was carried out among 585 adults aged 16+ in England between September and December 2019.
• The survey sample was self-selecting and promoted through multiple channels including Samaritans’ website and social media channels and a wide range of organisations working on related topics.
• 17 in-depth interviews were carried out in February and March 2020 with a sub-sample of survey participants who had self-harmed in the last two years. We spoke to people from across England and from a mix of ages, to ensure we heard a range of views and experiences.
• Our survey recorded the support people sought after the most recent time they had self-harmed. “NHS mental health support” (25%) includes self-referrals, GP referrals, support from an existing mental health contact and A&E attendance.
• Our survey found that people without a long-standing mental health condition were less likely to seek support from healthcare after their most recent self-harm (20% vs 37%). People without a long-standing mental health condition were more likely to say healthcare had not been useful for their self-harm (55% vs 35%). A long-standing mental health condition was defined as “mental health conditions or illnesses lasting or expected to last for 12 months”.
• Data from the Adult Psychiatric Morbidity Survey shows that lifetime self-harm rates have increased from 2.4% in 2000 to 6.4% in 20141.
• Samaritans Media Guidelines on reporting self-harm can be found here.
• Anyone can contact Samaritans FREE any time from any phone on 116 123, even a mobile without credit. This number won’t show up on your phone bill. Or you can email [email protected] or visit www.samaritans.org.