This guideline covers the short-term management and prevention of self-harm in people aged 8 and over, regardless of whether accompanied by mental illness. It covers the first 48 hours following an act of self-harm, but does not address the longer-term psychiatric care of people who self-harm.
In November 2011 recommendations 188.8.131.52 and 184.108.40.206 on assessment of risk, 220.127.116.11 on special issues for children and young people, and 18.104.22.168 on psychological, psychosocial and pharmacological interventions were replaced with recommendations from self-harm: longer-term management.
This guideline includes recommendations on:
- issues for all services and healthcare professionals
- care in primary care, by ambulance services, in emergency departments and the medical and surgical management of self-harm
- support and advice for people who repeatedly self-harm
- psychosocial assessment
- referral, admission and discharge
- special issues for people under 16 years and older than 65 years
- psychological, psychosocial and pharmacological interventions
Who is is for?
- Healthcare professionals
- Counsellors, psychiatrists, prison health staff, social workers, therapists pharmacists
- Police and professionals who work in the criminal justice and education sectors
- Directors of public health, NHS trust managers and managers in primary care trusts
- People who self harm and their families and carers
Is this guideline up to date?
We reviewed the evidence in September 2016. We identified no major studies that will affect the recommendations in the next 3–5 years.
Next review: 2021
Guideline development process
This guideline was previously called self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.