Crisis, self-harm and suicide


NICE Clinical Guideline [CG133] – Self-harm in over-8s: long term management -2011) - This guideline covers the longer-term psychological treatment and management of self-harm in people aged 8 and over. It aims to improve the quality of care and support for people who self harm and covers both single and recurrent episodes of self-harm.

NICE Quality Standard [QS34] – Self-harm -2013) - This quality standard covers the initial management of self-harm and the provision of longer-term support for children and young people -aged 8 to 18) and adults -aged 18 and over) who self-harm.

Useful resources

Hub of Hope - A directory of local services for support with a wide variety of mental health and related issues.

National Suicide Prevention Alliance - A broad range of resources here on suicide prevention and bereavement support - This site is for people in crisis, but it is helpful to spend some time with patients making a safety plan, although they can do this without professional support.

Patient and carer information

Breathing Space - A telephone line for out-of-hours support for over-16s in Scotland.

CALL Helpline Wales - They can be contacted for mental health support and advice via both telephone and text message.

CALM - The Campaign Against Living Miserably movement predominantly focuses on support for men, but this is not exclusive. There are a multitude of help guides on their site, as well as a helpline and webchat.

NHS England - This site will take people to an urgent mental health helpline 24/7, no matter where they are in England.

No Panic - Aside from information, this charity offer a support line and a crisis message for people to listen to when they are having a panic attack.

Papyrus UK - This charity is focused on suicide prevention in children and young people. There are crisis contacts, information for parents/carers and also for professionals on how to support young people who are struggling with their mental health, especially if they are experiencing suicidal ideation.

Prevent Suicide - A Scottish-based suicide prevention app and website offering a range of support options for people who may be in distress. The app gives users who may be at risk of suicide the option to write their own safety plan with helpful prompts to guide the user through the process.

Royal College of Psychiatrists - Information for patients, carers, family and friends relating to mental health problems and disorders.

Samaritans - Available 24/7 by calling 116 123 -free) or emailing -24h response time)

Shout  - Crisis text line - text Shout to 85258 - A site for people in suicidal crisis, with support to make a safety plan and links to other resources.

Support after Suicide Partnership - The Support After Suicide Partnership brings together suicide bereavement organisations and people with lived experience, to offer timely and appropriate support for everyone bereaved or affected by suicide. The timeline of what happens after a suicide, and how people may be feeling, is particularly helpful.

Silence of Suicide - This is for anyone who wants to support with their mental health in general, or in crisis.

Survivors of Bereavement by Suicide - This is a peer-led organisation offering peer-to-peer support to all those over the age of 18, impacted by suicide loss in the UK.

Further information and reading

Connecting with People - 4 Mental Health are an organisation delivering Connecting with People training – modular training sessions on a wide range of mental health subjects, including suicide and self-harm mitigation.

Distress Brief Intervention - This Scottish initiative, called DBI, consists of two parts, with part 1 seeing trained front-line health, police, paramedic and primary care staff help ease any individual.  They then ask the person if they would like further support and, if they agree, they are referred to the DBI service with a promise of contact within the next 24 hours to start providing further face-to-face support.

Mughal, F., Troya, MI., Dikomitis, L. et al. Role of the GP in the management of patients with self-harm behaviour: a systematic review. BJGP 2020; 70 -694): e364-e373 - GPs recognise self-harm as a serious risk factor for suicide, but some feel unprepared for managing self-harm. The role of the GP is multidimensional and includes frontline assessment and treatment, referral to specialist care, and the provision of ongoing support.

Oxford University Centre for Suicide Research – Clinical guide: Assessment of suicide risk in people with depression - The guide was developed to assist clinical staff in talking about suicide and assessing suicide risk with people who are depressed.

RCGP eLearning module – Mental health and suicide prevention - This module is one of a suite of courses looking at the health, wellbeing and service provision issues for patients who identify as lesbian, gay, bisexual or transgender -LGBT).

RCGP eLearning course – Suicide prevention - This course gives a clearer idea of when suicidal risk needs to be considered, sources of support, resources for yourself and your patient, and an appreciation of the next steps in suicide prevention training.

University of Manchester - National Confidential Inquiry into Suicide and Safety in Mental Health - This study has collected in-depth information on all suicides in the UK since 1996. Their recommendations have improved patient safety in mental health settings and reduced patient suicide rates, contributing to an overall reduction in suicide in the UK.

University of Manchester – Safer care for patients with personality disorder -2018) - This report examines the characteristics of patients with a diagnosis of personality disorder prior to suicide or homicide.