NICE publish new guidance on the long-term management and treatment of self-harm

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This new guideline published today suggests that psychological interventions should be offered to people who self-harm to help them overcome their behavioural problems.

Specifically it recommends that healthcare professionals should offer 3-12 sessions of a psychological intervention that is specifically structured for people who self-harm.

The intervention should aim to reduce self-harm and should be tailored to individual need and could include cognitive-behavioural, psychodynamic or problem-solving elements.

Therapists should be trained and supervised in the therapy they are offering to people who self-harm. Therapists should also be able to work collaboratively with the person to identify the problems causing distress or leading to self-harm.

As usual, the guidance comes with a wide range of supporting documents, implementation tools and podcasts.  The guideline accompanies an earlier publication from NICE, which focused on the short-term management of self-harm. That guideline is due to be reviewed in February 2012.

Professor Tim Kendall, Director of the National Collaborating Centre for Mental Health who helped develop the recommendations, said:

Self-harm is very common and involves a wide range of methods, the most common being self-poisoning with prescribed or over the counter medicines, or by cutting.

People self-harm for numerous reasons, and although self harm is not usually an attempt at committing suicide, it is a way of expressing deeper emotional feelings, such as low self-esteem, the emotional results of previous abuse and hurts.

However, people who self harm are much more likely to die by suicide, and many suffer from long term physical effects of self injury and self poisoning, as well as psychiatric problems such as depression. It is very important that we help identify people who self harm sooner and to help them come to terms with the underlying problems and access treatment when they need it. This guideline is a really important step to achieving this.

Professor Navneet Kapur, Professor of Psychiatry and Population Health at the University of Manchester and Chair of the Guideline Development Group, said:

People may keep self-harm a secret which means it is difficult to know how widespread it is.

Many cases are unreported unless medical treatment is required. However, it is thought to be common, especially amongst young people, with one UK study finding that 1 in 10 girls aged 15-16 had self-harmed in the previous year.

This new guideline is an important step in improving health professionals’ understanding of self-harm and thereby helping to ensure people receive the treatment and support they need.

If you need help

If you need help and support now and you live in the UK or the Republic of Ireland, please call the Samaritans on 116 123.

If you live elsewhere, we recommend finding a local Crisis Centre on the IASP website.

We also highly recommend that you visit the Connecting with People: Staying Safe resource.


Self-harm (longer term management). NICE, 23 Nov 2011.

Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. NICE, July 2004.

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