Self-harm: Australian treatment guide for consumers and carers, 2005

Why should I get help for self-harm?

Page last updated: June 2005

How do I get professional help?
What will happen if I go to the emergency department?
Can the hospital help me find mental health care?
How can I help myself?
What does treatment cost?
Contacts and plan for getting help

Of those who present to a hospital after self-harm, about half will never attend with the problem again.

Others attend hospital again after repeating self-harm. This increases the chance of the behaviour becoming a habit as a response to distress.

Research shows that 1% of those who self-harm die by suicide within the first year of first going to hospital with the problem.

Some people die by accident after self-harm because of the seriousness of their injuries or the substance they took.

It is OK to ask for help before you hurt yourself!

About half of all people who attend hospital after self-harm do so only once. Treatment teaches you new coping skills.

How do I get professional help?

It is important to get help whenever you have thoughts of self-harm. Except in a medical emergency, a General Practitioner (GP) is often the first place to get help. It is best to make an appointment so that you can discuss your situation without feeling rushed.

You do not have to be physically sick to see a GP. It is OK to talk to GPs about your feelings, problems, your lifestyle and your overall wellbeing.

You can ask the GP to arrange for you to meet with a mental health professional trained in providing treatments to reduce self-harm. GPs can also work jointly with you and a mental health professional in the longer term. In Australia, there are special payments for GPs to do this.

You may also contact mental health services directly – free public mental health services are listed in the front pages of the phone book. They have 'crisis teams' or 'crisis and assessment teams' (CAT teams). Many also have workers who specialise in helping young people. Often, they will come to you and some are contactable 24 hours a day, at least by telephone. They can arrange assessment and professional counselling with a psychiatrist, psychologist, social worker, occupational therapist or a mental health trained nurse.

You can also call a help-line. These are also listed in the phone book and in many public phone boxes. They can't provide 'therapy' over the phone, but can help you over the initial crisis of feeling out of control, alone and unsafe. Their purpose is support and referral. Top of page

What will happen if I go to the emergency department?

If you have already injured yourself, it is likely you will end up in the hospital emergency department. Medical and nursing staff will first treat your injuries:
  • They will assess you mentally and physically
  • You may be monitored for blood pressure, pulse, have blood tests and an electrocardiogram (ECG)
  • If you have taken an overdose, you may be asked to drink charcoal in water – sometimes a tube is put into your nose to your stomach and sometimes it is necessary to have your stomach pumped out to remove the overdose
  • With overdoses, you may be given other medication (either orally or via a drip into your blood vessel) to counteract the overdose
  • Other medical or surgical procedures may be required for your injuries.

Can the hospital help me find mental health care?

It is an important part of the emergency department's job to link you with a mental health worker for psychological assessment and treatment after self-harm or to find other forms of support. For example:
  • Staff may talk to a member of your family or a friend to decide whether or not you will be safe to go home - this is to see what support you have if you leave hospital
  • They may contact your GP to discuss the idea of you seeing him or her for counselling after you leave hospital
  • They may introduce you to, or give you the name of, a mental health professional who can work through the problems that led you to harm yourself.
A minority of people are admitted to hospital after self-harm. Usually this is to treat a psychiatric illness where the person cannot be treated at home. However most mental health care is provided on an out-patient basis in your local area and on an appointment basis. Top of page

How can I help myself?

Research shows that between 41 to 70% of people who self-harm do not keep appointments with health professionals. The steps toward helping yourself include:
  • Decide to keep appointments
  • Find a skilled professional who you can trust and work with
  • Find out if they are actually trained to work with people who self-harm (usually a psychiatrist or psychologist) so that you have the greatest chance of overcoming the problem
  • Always remind yourself of the positive skills you have and build on these.

What does treatment cost?

  • Many GPs bulk bill so that Medicare will cover the full cost. If they don't bulk bill, Medicare will refund you up to 85% of the cost if you visit the GP's surgery. Medicare will refund you 75% of the fee for GP care in a hospital or aged care facility.
  • When seeing a psychiatrist outside of hospital, Medicare will cover 85% of the scheduled fee and you pay the balance. Medicare will pay 75% of the cost if you are treated by the psychiatrist whilst a patient in hospital. This may seem expensive, but you may only go once per month for a few visits.
  • The care you receive in a hospital emergency department is provided for free.
  • Community mental health services are free clinics where you can see a psychiatrist, psychologist or social worker or other health professional by appointment. Usually, you should make several appointments a week or more apart over a number of weeks.
  • Medicare does not cover the cost of treatment if you see a psychologist, nurse or social worker privately. These visits usually cost between $60 and $120 for a one-hour session.
  • In Australia, there are now ways that GPs can work with other health professionals so they can offer you a longer consultation and an expert second opinion. Top of page

Contacts and plan for getting help

My GP's name:
Telephone:
My local mental health service location:
Key worker name:
Telephone:
After hours crisis team telephone:
Help line telephone:
My most reliable and trustworthy support person:
Telephone:

Keeping the first appointment is a step toward helping yourself.