5.1 Self-harm, suicide and mental illness

Unfortunately, sometimes – even if someone has been receiving treatment – an individual may experience great distress that results in urges to self-harm or attempt suicide.

Self-harm and suicidal thoughts are sensitive topics, and many people are unsure how to raise their concerns if someone they know is hurting themselves or appears to be thinking of ending their own life.

Self-harm and suicide are addressed in the same module because, although they are closely related to specific mental illnesses, they are not diagnoses in their own right – they can occur in people diagnosed with various mental illnesses but also in those who have never been diagnosed at all.

Not everyone who self-harms is suicidal, and not everyone who is suicidal self-harms. However, over half the people who die by suicide have a history of self-harm.

Around 10% of young people engage in self-harming behaviour at some point, but it is seen in people of all ages and backgrounds.

5.2 Forms of self-harm

Common forms of self-harm include punching, hitting, scratching, cutting and burning. People self-harm to express their distress, to draw the attention of others, to punish themselves or to relieve psychological tension.

Self-harming behaviour is usually treated with therapy that helps a patient explore underlying problems and develop healthier coping mechanisms during times of distress. If the patient is also anxious or depressed, they may be prescribed medication.

5.3 Suicide

Suicide is the act of deliberately ending one’s own life.

People can feel suicidal for many reasons, including trauma, relationship problems and the suffering that accompanies mental illness.

Signs that someone is thinking about suicide include:

• Reckless actions


• Giving away possessions


• Withdrawing from family and friends


• Mood swings


• Obtaining large amounts of medication or items they could use to end their life


• Frequent self-deprecating remarks

However, some people give no indication that they plan to kill themselves.

5.4 What to do if you discover someone is self-harming or considering suicide

If you think that someone is self-harming or is having suicidal thoughts, it is important to approach the issue with sensitivity and understanding. Remember that they are likely to be in a vulnerable state of mind and may resent what they perceive to be unwanted attention. Focus on their feelings rather than their actions. They may not be ready to talk straight away – this is normal.

Simply letting them know that you are willing to listen – without passing judgement – can help.

Do not issue ultimatums such as “Stop self-harming or move out!” or “Stop doing that, or you’ll be fired!” Don’t make them feel guilty over the effect their feelings may have on other people.

Neither approach is constructive. In fact, they will only add to the individual’s distress. Refer them to an employee assistance programme, if applicable, and encourage them to see a mental health professional to discuss their feelings.

Contrary to popular belief, merely talking to someone about their suicidal thoughts does not increase the chance that they will act upon them. Remember too that if someone commits suicide or continues to self-harm despite your support, you are in no way to blame for their actions.

However, it is sometimes necessary to take immediate action. If their self-inflicted injuries are serious or life-threatening, or if someone appears to be at imminent risk of suicide, treat the situation as a medical emergency and call for an ambulance.