Self-Harm: Getting Help and Treatment

If you are hurting yourself, or you love someone who is, please know this first: you are not alone, you have not done anything shameful, and things can get better. Self-harm is a way of coping with feelings that have become too much to bear, not attention-seeking and not a sign of weakness. With the right support, people do recover, and the distress underneath the self-harm can be understood and treated.

This page explains why people self-harm, how it is treated, and how to get help, including how to arrange a private assessment at Cardinal Clinic. Whatever you are going through, reaching out is a strong and sensible thing to do.

If you need help right now

If you have seriously harmed yourself, or you feel you are in danger now, call 999 or go straight to your nearest A&E. This is the right thing to do, and the people there will want to help you.

For urgent support when it is not a life-threatening emergency:

• NHS 111: call 111 and choose option 2 for the mental health service, available day and night.
• Samaritans: call 116 123, free, any time, day or night, to talk to someone who will listen without judgement.
• Papyrus HOPELINE247 (for anyone under 35, and those worried about a young person): call 0800 068 4141.
• SHOUT: text SHOUT to 85258 for free, confidential support by text message at any time.

You do not have to be in crisis to use these services. If things feel like too much, it is always okay to reach out.

Clinically reviewed by Robin Lefever, Director & Therapist (Registered Manager). Last reviewed: 22 June 2026.

Talk to us about an assessment. If you would like a compassionate, confidential assessment, you can refer yourself to Cardinal Clinic directly, or contact us to talk through your situation and the right next step.

Why do people self-harm?

People self-harm for many different reasons, but at the heart of it, self-harm is usually a way of coping with overwhelming emotional pain. When feelings such as distress, numbness, anxiety, shame, anger, or hopelessness become too much, hurting yourself can feel like the only way to release the pressure, to feel something, to regain a sense of control, or to punish yourself for things you blame yourself for.

The NHS describes self-harm as a sign that someone is struggling and needs support, not as something done for attention. It can affect anyone, of any age and any background. For many people it becomes a pattern that is hard to stop on their own, even when part of them wants to, because the underlying distress has not yet been addressed.

Understanding self-harm this way matters, because it points to what treatment is really for: not simply stopping the behaviour, but understanding and easing the distress that drives it. When the underlying pain is met with the right help, the need to self-harm tends to ease.

How is self-harm treated?

Self-harm is treated by addressing the distress underneath it. NICE NG225 recommends a psychological therapy aimed at reducing self-harm, usually DBT or CBT, alongside safety planning, treatment of any co-occurring condition such as depression, and ongoing support.

Effective treatment for self-harm focuses on the distress underneath it, rather than on the behaviour alone. The aim is to understand what self-harm is doing for you, to build safer ways of coping, and to treat any underlying or co-occurring difficulties.

NICE guideline NG225 (Self-harm: assessment, management and preventing recurrence) sets out the evidence-based approach. It begins with a compassionate, non-judgemental assessment that looks at your circumstances, your feelings, your risk and safety, and what support would help. From there, treatment usually involves a combination of the following:

• Psychological therapy. NICE NG225 recommends offering a psychological therapy specifically aimed at reducing self-harm. The best-evidenced approaches include dialectical behaviour therapy (DBT), which helps with managing intense emotions, tolerating distress, and building safer coping skills, and cognitive behavioural therapy (CBT), which helps you understand and change the thoughts and patterns that feed the distress. The right therapy depends on your situation and is decided together at assessment.
• Treating any co-occurring condition. Self-harm often sits alongside another difficulty, such as depression, anxiety, the effects of trauma, or borderline personality disorder (sometimes called emotionally unstable personality disorder). Treating these as part of the same plan, rather than separately, is central to recovery.
• Safety planning. A safety plan is something you create with a clinician: it identifies your warning signs, the things and people that help, ways to make your environment safer, and who to contact when distress rises. NICE NG225 highlights safety planning and ongoing support as an important part of reducing the risk of further self-harm.

Treatment is collaborative and paced to what you can manage. It is not about being told off or made to feel judged. It is about being understood and given real, practical tools alongside care for the feelings underneath.

When is inpatient or more intensive treatment needed?

Many people who self-harm can be supported effectively through outpatient therapy. But for some, more intensive treatment, including day-patient or inpatient (residential) care, is the safer and more helpful option for a period of time.

More intensive care may be appropriate when:

• The frequency or severity of self-harm is escalating, or feels increasingly hard to manage.
• There are thoughts of suicide, or you do not feel able to keep yourself safe at home.
• Self-harm sits alongside severe depression, an eating disorder, trauma, or alcohol or substance use that needs coordinated treatment.
• Distress is overwhelming and difficult to manage between weekly sessions.
• Home is not a safe or stable enough environment to recover in right now.
• Outpatient support has not yet been enough.

As a consultant psychiatrist-led private hospital, Cardinal Clinic can provide inpatient care that offers a safe, contained environment with daily clinical support and a multidisciplinary team. Inpatient treatment can give you space to stabilise, away from the pressures driving the distress, before stepping down to day-patient or outpatient therapy as you recover. Needing this level of care is not a failure; it is sometimes simply the right amount of support at the right time.

Choosing the right level of care

People often ask which level of care they need. There is no single correct path, and many people move between levels over time, stepping up for more support and stepping down as they stabilise. The levels below set out how they differ and who each tends to suit.

Outpatient therapy

• Who it tends to suit: people who are managing safely day to day and can attend regular sessions and use what they learn between them. Often the right starting point.
• When to consider stepping up: if self-harm escalates, risk rises, or progress stalls despite consistent therapy.

Day-patient programme

• Who it tends to suit: people who need more structure and clinical contact than weekly therapy, but who can return home each day to a stable enough environment.
• When to consider stepping up: if safety cannot be maintained at home, or distress becomes too severe for daytime-only support.

Inpatient (residential) care

• Who it tends to suit: people who need a safe environment and daily multidisciplinary support, often where risk is significant or co-occurring conditions need coordinated treatment.
• When to consider stepping up: this is the most intensive level; step-down to day-patient or outpatient care follows as you stabilise.

At assessment, our consultant psychiatrist-led team recommends a starting point based on your safety and needs, and reviews it as treatment progresses.

How to get help

Reaching out is the hardest and most important step, and there is no wrong way to do it. You might:

• Tell someone you trust, a friend, a family member, or anyone you feel safe with. Saying it out loud, even once, can begin to ease the weight of it.
• Speak to your GP, who can talk through what is happening, check on your physical health, and help you access support.
• Arrange a private assessment at Cardinal Clinic, where a clinician will listen, help you make sense of what you are going through, and recommend the right treatment.

You can refer yourself to Cardinal Clinic directly, without waiting for a GP letter. You do not need to have everything worked out, and you do not need to be at your lowest point to ask for help. Wanting things to be different is reason enough.

How to help someone who self-harms

If someone you care about is self-harming, your response can make a real difference, even when you do not know what to say. You do not need to have the answers; being there, calmly and without judgement, is what helps most.

• Listen without judgement. Let them talk in their own words, and try to understand what they are going through rather than focusing on the behaviour itself. Knowing they can tell you without being judged is often a relief in itself.
• Stay calm. It is natural to feel upset or frightened, but try not to express shock, anger, or disgust. Reacting strongly can leave them feeling more ashamed and less able to confide in you.
• Do not demand they promise to stop. Asking someone to promise to stop, or issuing ultimatums, tends to add pressure and secrecy rather than help. Self-harm is usually a way of coping, and stopping safely takes the right support and time.
• Ask how you can help. A simple, open question such as what would help right now lets them tell you what they need, rather than you having to guess.
• Encourage them towards support. Gently encourage them to seek help, whether from a GP, a private assessment, or a service such as Samaritans on 116 123. You could offer to help them make a call or go with them to an appointment.
• Look after yourself too. Supporting someone who self-harms can be hard and draining. It is not selfish to seek support for yourself, whether from your own GP, a counsellor, or a helpline. You will be better able to help when you are looked after as well.

If a young person you care for self-harms: try to stay calm and approachable so they feel able to come to you, take what they tell you seriously without overreacting, and involve their GP or a specialist so they can be assessed and supported. Papyrus HOPELINE247 on 0800 068 4141 offers advice and support to anyone under 35 and to parents and carers worried about a young person.

When to seek urgent help: if they have seriously harmed themselves, or you believe they are in immediate danger, call 999 or go to your nearest A&E. If you are worried about their safety but it is not a life-threatening emergency, call NHS 111 (option 2 for mental health) or encourage them to talk to Samaritans on 116 123.

How we can help at Cardinal Clinic

Cardinal Clinic is a private psychiatric hospital in Windsor, Berkshire. As a consultant psychiatrist-led service, we offer care across every level of need, from outpatient therapy through day-patient programmes to inpatient (residential) treatment, which means we can support people whether their self-harm is recent and frightening or longstanding and entrenched.

Treatment begins with a thorough, compassionate assessment of your circumstances, your feelings, your safety, and any co-occurring conditions such as depression, anxiety, or the effects of trauma. From there, our multidisciplinary team builds a clear plan combining evidence-based psychological therapy, treatment of any underlying condition, and safety planning, in line with NICE NG225. You can read about our team and what an admission involves on our inpatient care page.

We see adults from across Berkshire, Surrey, and West London, and many people come to us specifically because we can offer the full range of care under one team. Cardinal Clinic is registered with and regulated by the Care Quality Commission (CQC). To begin, you can refer yourself or contact us to talk through your situation and the right next step.

References and sources

• NICE guideline NG225, Self-harm: assessment, management and preventing recurrence: https://www.nice.org.uk/guidance/ng225
• NHS, Self-harm: https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/self-harm/
• Samaritans (116 123); Papyrus HOPELINE247 (0800 068 4141); SHOUT (text 85258).

You do not have to cope with this alone

Self-harm can feel like a private struggle that is impossible to talk about, but it is more common than you might think, and it is treatable. Whatever has brought you here, reaching out for help is the turning point. Cardinal Clinic can help you understand what is happening, ease the distress underneath it, and find the right path forward, whether that is outpatient therapy, a day-patient programme, or inpatient care. You can refer yourself or contact us when you are ready.

A reminder about urgent help: if you have seriously harmed yourself or feel you are in danger now, call 999 or go to your nearest A&E. For urgent support, call NHS 111 (option 2 for mental health) or Samaritans free on 116 123, any time. If you are under 35, call Papyrus HOPELINE247 on 0800 068 4141, or text SHOUT to 85258.

This page is for information only and does not replace medical advice, diagnosis, or emergency care. If you feel unable to stay safe, are having thoughts of suicide or self-harm, or are at immediate risk, please seek urgent help using the numbers above. Author and clinical reviewer: Robin Lefever, Director & Therapist.