Going to your GP about self-harm

Talking to your doctor (GP) about self-harming can be a very daunting prospect. Will they be supportive, or will they judge you? The Mix gets you through your appointment as painlessly as possible.

Even though it's daunting, telling your GP you self-harm can help.

Your GP and self-harm treatment

You want to go to your GP about issues to do with self-harming, but you don’t know what to tell them and you’re worried about what reaction you’ll get. There are some guidelines from the National Institute for Clinical Excellence (NICE), which advises health professionals about self-harm and how they can understand and treat you.

NICE recommends that you should be offered a full assessment of your physical, psychological and social needs. This should be done by a professional who’s trained in the treatment of people who harm themselves, in an atmosphere of respect and understanding.

What does this mean?

Most GPs will be experienced in assessing and treating people with mental health problems, including where self-harm is an issue. If you’re joining a new practice it’s worth asking if one of the GPs has a particular interest in mental health.

“For people who’ve made the decision to go to the doctors it’s a big deal because they’re in huge amounts of distress and will be very concerned about how they’ll come across,” says Katie, 22. “Unfortunately, doctors can look at you from a medical perspective and in terms of symptoms and risk, rather than emotional angst. This doesn’t mean that you shouldn’t go or that they are not capable of understanding, but it might require some patience in explaining yourself.”

Questions you may be asked by your doctor

A referral from your GP will normally be required to get specialist mental health support on the NHS, so it’s important you provide your GP with as clear a picture as possible about what’s going on and the help you feel you need. The information that the GP needs to get from you in order to work out how best to help you includes:

• How do you self-harm?
• Where and how often?
• When did you start self-harming?
• What triggers it?

If you’ve cut or burned yourself, they may ask to see your injuries. This might feel uncomfortable and exposing, but a good GP will want to assess things like tissue damage, scarring, and infection risk in order to ensure you get any medical treatment you need. They will want to find out how you are feeling, whether you feel your self-harm is getting worse, if you’re depressed or suicidal, or a risk to yourself or others. They may ask questions about your sleeping, appetite, mood, and what is going on in your life, in order to establish this.

Some health professionals may appear shocked or frustrated by your actions if they don’t understand what you’re going through, but this kind of reaction is rare. It could be helpful if you can tell them what kind of help you would like, such as someone to talk to, or advice on self-injury care. If you have some idea of why you self-harm; you know that certain situations make you feel like self-harming; or you use self-harm as a way of coping but would like to stop, explain this to your GP. The more information they have the better able they are to work out what kind of help you need.

Things to consider:

You don’t need to do it alone: If you feel uncomfortable about going to see your GP on your own, take a friend or relative with you. They can provide support and help you remember what was said. But remember the consultation is about you and your needs, so think about what support you’d like to receive.

Be prepared: Think about what you want from your appointment before you go. Do you want to know about treatments or support networks in your area? Write down any questions you may have and take these with you. If you clam up in the appointment you can always hand these over to your GP.

Study notes: You may find it helps you to remember what you talked about if you write down the answers they give you, especially if nerves get in the way. Good doctors often have free printouts or leaflets you can take away with you, self-help strategies, and other support services in your area you may wish to consider.

Medical jargon: If something is said during your appointment that you don’t understand, don’t be afraid to ask what it means. At the same time, if you have a question after your consultation, your GP will usually be happy to chat to you on the phone. They may not be available at the exact time you call, but they should call you back on the same day.

Following up

If you don’t feel comfortable and don’t trust a particular GP or health professional, go elsewhere. You have the right to choose – what’s important is that you get the help you need and what feels best for you.

Photo of boy with GP by Shutterstock.