Self-Harm & Suicide
Support and tools for managing crisis situations
Content warning: This page may help you if you are dealing with self-harm and/or suicidal thoughts. It provides tools to help you in moments of crisis and signposts towards services you can access for additional support. This page discusses self-harm, suicidal thoughts and suicide, both in written content and in the videos. If this is something that makes you feel uncomfortable or upsets you, you might decide not to read the information below. You can also access the helplines & text services for further support.
What Is Self-Harm?
Self-harm describes any deliberate self-injurious behavior with the intent of harming oneself and can be suicidal or non-suicidal in nature. Self-harming is not a mental illness, but a behavior that is often linked to the experience of mental distress. Once self-harm is established, it can be difficult to stop and, although life-threatening injuries are usually not intended, there is an increased risk of inflicting more serious injuries that can lead to ending one's life.
Why Do People Self-Harm?
Everyone has their own reasons as to why they self-harm and these can change over time. It is important to remember that self-harm is not attempted suicide or a cry for attention. While some people who harm themselves also have suicidal thoughts, there are many other factors that motivate individuals to self-harm. In fact, the majority of people who self-harm do so as a way to cope with difficult or distressing thoughts and feelings. Other common reasons why people engage in self-harm behaviors include self-punishment, self-distraction, getting relief, reducing tension or gaining a sense of being in control.
Types of Self-Harm
Self-harm can take many forms. Some people use the same method all the time, others use different methods at different times. The box below lists some of the ways in which people self-harm. If you are feeling vulnerable at the moment, you might not want to read the information below.
- Cutting or scratching skin with knives, razors or other sharp objects
- Burning oneself with flames, heated metals, wax or chemicals
- Punching or hitting oneself either with fists or objects
- Binge eating and/or purging or starving oneself
- Compulsively pulling out large amounts of hair
- Picking or interfering with the healing of wounds
- Taking excessive risks, including dangerous sexual liaisons etc.
- Abusing alcohol and/or drugs for the risk rather than enjoyment
What Are Suicidal Thoughts?
Suicide is when someone intentionally ends their own life, often as a consequence of feeling overwhelmed by their circumstances.
Suicidal thoughts are thoughts of ending one's life. They can be passive i.e. the person has abstract thoughts about ending their life or feels that others would be better off without them; or they can be active i.e. the person thinks of specific methods of suicide or makes a clear plan to end their life.
Why Do People Have Suicidal Thoughts?
Suicidal thoughts can occur for any number of reasons and often it can be a mixture of different things. People with suicidal thoughts may be experiencing a range of emotions, such as feeling overwhelmed, hopeless, anxious, confused or useless. Someone thinking about suicide may feel that the pain and emotional distress they are facing is too much to cope with and that they have no other option than to end their life. The important thing to remember is that most people who attempt suicide do not want to die, they want their pain to stop.
If you are thinking about suicide or are recovering from a suicide attempt, please reach out for support – talk to someone you trust and feel comfortable with, such as a family member, friend, listening service, GP or other health professional. More information on recovery after a suicide attempt can be found here. With the right support at the right time, people can overcome their difficulties.
Tools For Managing A Crisis
These tools are not intended to replace therapy or professional advice. They are designed to help you cope with difficult feelings or situations that may arise. However, if you are really struggling please contact one of the emergency helplines provided or seek help from your GP.
Safety Box
A box filled with things to help you cope when you feel overwhelmed or hopeless.
Start NowSafety Plan
A written plan to keep you safe should you experience suicidal thoughts.
Start NowDistraction Techniques
Alternative coping strategies when thinking about self-harm or suicide.
Start NowSafety Box
A safety box has many names: happy box, hope box, emergency kit, crisis box – you can name it however you'd like. A safety box can be your anchor when facing crisis. The idea behind this box is that it is filled with things that can relax you and help you cope when you start to feel overwhelmed or distressed.
It contains a collection of physical items, written reminders and simple grounding activities to help you find safe alternatives to self-harming and distract you from suicidal thoughts. By looking at the items in your box, you can learn to question and change any negative thoughts by being reminded of your previous successes, positive experiences and reasons for living.
The purpose of a safety box is:
- To provide relief from stress, anxiety and overwhelm
- To prevent you from using unhealthy coping mechanisms
- To be personalised to your needs and preferences
- To remind you of reasons to live
1. Grab a bag, box or any other container that you can turn into your own personal safety box.
2. Think about what makes you feel better when you are at a low point and what has helped you when you have self-harmed or had thoughts of suicide in the past.
You can use the guide in the 'Download Materials' for ideas on what to include in your box. These can be items or activities that help you calm down or that distract you from your current situation.
We have also attached several helpful worksheets that you can fill out and put in your box alongside these items. Some of these are specifically designed for someone who self-harms or has suicidal thoughts, others can be helpful in both instances.
3. Whenever you feel the urge to self-harm or start to notice suicidal thoughts creeping in, you can use the box to help you feel better.
Key things to consider:
1) Keep your safety box somewhere safe and accessible so that you can find it easily when you need it.
2) If something in your safety box no longer brings you comfort or joy, remove and replace it with something that does.
3) Your safety box should be personal to you. This is really important, as everyone responds differently to different things.
Inspiration for your safety box: Safety Box Ideas
More helpful things you can print out and put in your box:
- Helplines: it is always important to have a list of helplines close to you in case you need immediate support.
- PMR Guide and 5-4-3-2-1 Technique: use these relaxation techniques when you are overwhelmed and need to calm yourself down.
- Distraction Techniques: for self-harm and suicide.
- Positive Affirmations for Self-Harm & Positive Affirmations for Suicidal Thoughts: during periods of distress or overwhelm, speak these positive statements out loud to help yourself calm down.
For those with suicidal thoughts:
- Your Safety Plan: a plan to help you stay safe should you experience suicidal thoughts.
- List of Dreams & Goals: a reminder of what motivates you to keep going and what goals you have in life.
- About Me: a reminder of all the things you, and others, like about yourself and that you are proud of.
Although the safety box is a helpful tool, it is sometimes difficult to keep it close at hand (e.g. when you are at work or on holiday).
As an alternative you can download the Virtual Hope Box, a free smart phone application (compatible with Apple & Android devices) which allows you to keep a virtual collection of tools and activities for coping, relaxation, distraction and positive thinking.
Safety Plan
A suicide safety plan is a written plan that you create for yourself to keep you safe should life become overwhelming and you begin to experience thoughts of suicide. It can help you navigate your thoughts and feelings and manage any urges to act on them.
Feeling suicidal is often the consequence of extreme emotional pain and distress combined with a lack of healthy strategies to handle these. Your safety plan can help you find ways of coping with the situation until you are safe.
The plan involves three main parts:
1) Identifying when your suicidal thoughts have been triggered.
2) Activities you can do to keep yourself safe.
3) Helplines and services you can access for further support.
Try to create your safety plan at a time where you are feeling well and can think clearly. It is a good idea to write your safety plan with the help of someone you trust and that knows you and your needs well. This could be a friend, family member, counsellor or social worker.
Once you have written your safety plan, keep it in a place where you can easily find it should you need it. If you have a Safety Box, you can also put a copy of your safety plan in there.
Should you begin to experience suicidal thoughts, take out your safety plan and follow each of the steps that you previously outlined for yourself until you are feeling safe. Should you feel like you are losing control or experience strong urges to act on your suicidal thoughts, contact 911 for emergency help.
Lastly, while it is important that your safety plan is unique to you, it can be helpful to share it with people you trust. This can help them understand what you are going through, how they can best support you and how to hold you accountable should you face a crisis.
Your Safety Plan
Distraction Techniques
Self-harm is a coping mechanism, often used to deal with difficult situations and/or emotions. Whilst the idea of stopping can seem impossible for some people, it is important to realize that there are alternative options that can help reduce the frequency/severity of self-harm behaviours, whilst allowing you to maintain a sense of control.
For some people it can be helpful to use distraction techniques or replacement behaviours when they want to self-harm. Different distraction techniques work for different people and the same type of distraction won't necessarily work for you every time.
The next time you feel like self-harming, take a moment and ask yourself why. Understanding the emotions behind your urge to self-harm can help you match how you act to how you are feeling. For example when feeling angry, physical activity such as going for a run may give you relief. When feeling numb, it might be helpful to do something that comforts you and gives you a pleasant sensation.
Go to the 'Download Materials' for inspiration on distraction techniques you could use. You can print out the 'Distraction Techniques' sheet and keep it somewhere accessible so that when you feel the urge to self-harm you can find something that works for you to help delay or reduce your self-harm. If you have a Safety Box, you can also put a copy of the sheet in there.
For more coping strategies and self-soothing techniques, explore our coping strategies and our mindfulness & meditation modules.
Note: it can be hard to focus on distractions if you haven't taken care of your basic needs first. Before starting a distraction technique, try to HALT and ask yourself whether you are currently Hungry, Angry, Lonely or Tired.
When experiencing suicidal thoughts, it can be helpful to distract yourself as part of your plan to stay safe. Distraction techniques can help you focus your mind on something else, allowing time for the thoughts to pass.
Different distraction techniques work for different people, and the same type of distraction won't necessarily work for you every time. Go to the 'Download Materials' for inspiration on distraction techniques you could use. You can print out the 'Distraction Techniques' sheet and keep it somewhere accessible so that when you notice suicidal thoughts occurring, you can find something to help distract your mind and keep you safe. If you have a Safety Box, you can also put the sheet in there.
For more coping strategies and self-soothing techniques, explore our coping strategies and our mindfulness & meditation modules.
Note: it can be hard to focus on distractions if you haven't taken care of your basic needs first. Before starting a distraction technique, try to HALT and ask yourself whether you are currently Hungry, Angry, Lonely or Tired.
- Distraction Techniques for Self-Harm and Suicidal Thoughts
- HALT Method
The mental health charity Heads Above The Waves also provides a great overview of things you can try to distract yourself. You can access them here.