“Self-harm (SH) is the collective term for self-mutilation, self inflicted violence or self-injury behaviours. The act of SH is without conscious suicidal intent and is often followed by relaxation and relief. SH can be a coping mechanism, frequently born out of trauma, psychological illness, abuse, a deep-seated sense of powerlessness or negative feelings (such as anger, guilt, frustration, hopelessness and self-hatred; MIND, 2010). Often the overwhelming emotional feelings are converted into a visible, physical wound, which the individual can find easier to deal with (Sutton, 2007).”

Wounds UK has published a document ( accessible for download below)  that suggests the creation and use of rescue packs by those who regularly self harm is of benefit.  “If it is not possible to stop SH behaviours, encouraging self care education is vital (Hunt, 2017). Good communication, observational support, and clear objective agreement are required to ensure that patients who SH remain safe. Patient self-care and timely intervention can reduce attendance to services and hospital admissions. This has a direct cost saving to the healthcare provider allowing reducing resources to be utilised appropriately (Ryan et al, 2009). Using products that are easy and simple for the individual to use improves patient confidence, reassurance and ownership for the patient within their self-care pathway while reducing the reliance on the clinician (Bateman, 2014; Dowsett, 2015).”

Examples of self harm include the following:

  •  Skin burning, scalding and erasing (rubbing off layers of skin)
  • Skin cutting, slashing, carving (words, symbols or dates)
  • Neurotic excoriation or dermatilliomania (compulsive skin picking)
  • Excessive scratching (sufficient to cause bleeding and scarring)
  •  Insertion of objects into the genitals with the purpose of causing tissue damage (non-sexual intent)
  • Self-punching, hitting, slapping, biting or bruising
  • Self-stabbing with sharp objects
  • Head banging
  • Trichotillomania (hair pulling from scalp, eyelashes, eyebrows)
  • Interfering with wound tissue or dressings to obstruct healing
  • Insertion of needles under the skin and into veins
  • Swallowing foreign objects resulting in internal tissue damage
  • Bone breaking

Practical Tips for those who are working with patients or clients who self harm:

  • Build a non-judgemental, supportive and trusting relationship
    Be brave and ask the question: ‘are you self-harming?’
    Explore patient’s rationale, how and why they self-harm
    Ensure that contact details of relevant services are in the‘rescue pack’
    Ensure that replacement pack processes are in place (such as prescription repeats)
  • Ensure that ‘red flags’ in regards to wound care and patient safety are emphasised
    Review any tissue injury
    Refer to appropriate specialists in regards to emotional, psychological and social needs so that a holistic care package is in place
    Provide a self-care ‘rescue pack’ if appropriate
    Discuss self-care and keeping safe Ensure that ‘rescue pack’ information is given verbally and in writing
    Ensure that the contents and the use of ‘rescue packs’ are clear and understood

The article provides examples of the content suggested for the rescue packs.

Download self Harm Wound Information

The Nursing CPD Institute provides great information and CPD  on an array of nursing topics including wound care in a range of easy learning ways including webinars and quizzes on the latest information that Nurses need to know – remember it was created by Australian Nurses for Nurses!  https://www.ncpdi.com.au