Self-harm - what you need to know. - Chia Sẻ Kiến Thức Điện Máy Việt Nam

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Help & treatment

What professional help can I get?

If you want professional help to manage and recover from self-harm you can make an appointment with your GP. You may find it difficult to ask for help. GP’s are trained to deal with these conversations, and are used to talking about mental health with their patients.

Be honest about why you self-harm. People self-harm for different reasons. This will help professionals to find the right support for you.

Don’t give up if the first treatment option you try doesn’t work. There are different treatment options, so other treatments might be better for you.

The National Institute for Care and Excellence (NICE) produces best practice recommendations for health care providers to follow. The NHS don’t have to follow them, but there should be good reason if they don’t.

The two main ways recommended by NICE to manage self-harm are:

Short term management of self-harm, and
Long term management of self-harm.

You can access the NICE guidelines by clicking on the following links:

Self-Harm in over 8’s: short term management and prevention of
reoccurrence: www.nice.org.uk/guidance/cg16
Self-harm in over 8’s: long term management:
www.nice.org.uk/guidance/cg133

Short term management of self-harm

Your GP can support you in the short-term management of self-harm. They will help you, regardless of whether you have a mental illness. Your GP will listen and discuss with you the best treatment options for you.

What treatment should I be offered?
Your GP may talk through with you ways to manage your self-harm, such as by making lifestyle changes. They may also suggest you join a support group. They can also give you advice and treatment for minor injuries. Your GP might ask you to come back for another appointment to see how you’re doing.

Medication shouldn’t be offered to you to reduce your self-harm. But medication may be offered to you to help with symptoms of other mental health conditions. Doctors will think about risk of overdose when prescribing medication.

Harm Reduction
If you can’t stop self-harming, your GP may talk to you about developing harm reduction techniques, such as:

developing new strategies that are different to self-harm, and
discussing less harmful methods of self-harm.

There is no safe way to self-poison.

Referral to specialist mental health team
Your GP may think about referring you to a specialist mental health team if:

things that the GP has tried doesn’t work for you,
your levels of distress are getting worse or are high all the time,
you’re experiencing symptoms of a serious mental illness,
your self-harm risk is getting worse, or
you ask your GP to refer you to one.

Your GP should still monitor your physical health.

Mental health services may become responsible for your mental health treatment and care. They may put you under the ‘Care Programme Approach’ (CPA).

Long-term management of self-harm

If you need long-term management for your self-harm, your GP may offer you an assessment with your local community mental health team (CMHT). This assessment will be done to help you receive specialist support to reduce or stop your self-harm. If the CMHT can offer you help, you may be put under the Care Programme Approach (CPA).

What is the Care Programme Approach (CPA)?
If you’re under the care of specialist mental health service and have ‘complex needs’ you may be put under CPA. Someone who self-harms a lot might have complex needs. If you’re under CPA you will have a care plan. Your care plan explains what support you need to manage and recover from your self-harm. This should contain information such as:

how to stop your self-harm from getting worse,
how to reduce or stop harm caused by your-self harm,
how to lessen risky behaviours,
how to improve your ability to function, and
how to improve your quality of life.

Your care plan should also:

identify goals that you would like to achieve in life, such as employment goals,
identify team members and what they should be doing for you,
include a risk management plan,
identify short term goals linked to your-self harm, and
be shared with your GP.

You should have a say about what is written into your care plan. Your family or carers should also be involved if you agree. Your care plan should be reviewed every year, these meetings are usually called ‘CPA meetings’.

What is a risk management plan?
Risk management should be part of your care plan. It should look at:

current risk,
long term risk,
things that increase your risk of self-harm, and
a crisis plan.

A crisis plan gives you steps to take in a crisis such as a number to call or distraction techniques to try. Your crisis plan is tailored to your needs, and what will work best for you if you’re in a crisis. The aim of a crisis plan is to think about what support you need when you are in crisis.

What treatment should I be offered?
Your mental health team should think about giving you 3 – 12 sessions of talking therapy to help you to stop self-harming. These sessions may start by your therapist helping you to find different ways of coping with painful emotions.

Your therapist should work with you to help you find the reasons why you self-harm. Your therapy should be tailored to your needs. There are many different types of therapy. You may be offered:

cognitive behavioural therapy,
psychodynamic therapy, or
problem solving therapy.

Your therapist should help you understand the reasons why you self-harm.

You can find more information about ‘Talking therapies’ by clicking here.

Harm Reduction
If you can’t stop self-harming in the short term, you can talk with medical professionals about harm reduction, such as:

developing new strategies that are different to self-harm, and
discussing less harmful methods of self-harm.

There is no safe way to self-poison.

Ending care with the specialist mental health team When your treatment and care is due to end professionals should:

tell you what is likely to happen when your care ends
tell you ahead of time so that you can get used to the change
give you extra support if you need it,
make sure you have a clear crisis plan in place,
share your care plan with any other professionals who are taking over your care,
give you a copy of your plan and what has been agreed, and
give your family or carer a copy of the plan if you agree

You can find more information:

Talking Therapies by clicking here.
Care Programme Approach by clicking here.
Medication – choice and managing problems by clicking here.

What if I am not happy with my treatment?

If you aren’t happy with your treatment you can:

talk to your doctor about your treatment options,
ask for a second opinion,
get an advocate to help you speak to your doctor,
contact Patient Advice and Liaison Service (PALS), and see whether they can help, or
make a complaint.

There is more information about these options below.

Treatment options

You should first speak to your doctor about your treatment. Explain why you aren’t happy with it, giving specific reasons. You could ask what other treatments you could try.

Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you’re not given this treatment, ask your doctor to explain why they think it’s not suitable for you.

Second opinion

A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.

You don’t have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.

Advocacy

Advocates help you to deal with and overcome issues that you have. They are independent from the NHS and free to use.

They can be useful if you find it difficult to get your views heard. There are 3 types of advocates that might be able to help if you are unhappy about your treatment.

NHS complaints advocates can help if you want to make a complaint to the NHS. These are available in all areas.
Community or mental health advocates can support you to get a health professional to listen to your concerns. These are available in some areas only.
Independent Mental Health Advocates can help and advise you if you’re detained under the Mental Health Act.

You can find more information about ‘Advocacy’ by clicking here.

The Patient Advice and Liaison Service (PALS)

PALS is part of the NHS. They give information and support to patients and can help you to resolve issues.

You can find your local PALS through this website link:
www.nhs.uk/Service-Search/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363.

Complaints

If you’re not happy about your treatment or support, you can make a complaint. This is where your concerns are investigated in more detail.

You can ask an NHS Complaints Advocate to help you with your complaint. They are free to use and don’t work for the NHS.

You can find out more about:

Self-harm – what you need to know.