Confidentiality and self-harm

Telling someone about self-harm is hard, and whoever you tell should respect your right to privacy. However, there are times when they may have to let other people know. The Mix makes things clearer.

Worried that telling your GP means your parents will find out?

Who can I talk to about self-harm?

Telling anyone about your self-harm is a massive and brave step, so confide in someone you feel comfortable with. Talking to a trained health professional such as your doctor (GP), a counsellor or support organisation is a safe move because they should listen calmly and offer you objective advice. It might also be easier to open up to someone you’re not emotionally close to because you can relax and not worry about upsetting them. There’s no reason for you to deal with things all on your own; if you’re really worried about talking to someone face-to-face, you can call, email, or even text a professional support group anonymously.

What does confidentiality actually mean when it comes to self-harm?

Different people have different rules of confidentiality if you open up to them about self-harm. We talk you through the confidentiality guidelines of the main people you may turn to.

Will my doctor tell anyone I’m self-harming?

In most cases, no. All staff working for the NHS have a legal duty to follow the NHS Code of Practice on Confidentiality. This means they must ask for your consent before passing information to anyone else – this is part of their duty of care and applies whatever age you are.

What if I’m under 18?

If you’re aged 16 or 17, the law sees you as an adult when it comes to confidentiality and consent to treatment. Therefore, if you’re 16 and you want a health professional to keep your treatment confidential then that should be respected.

When will a doctor tell anyone I’m self-harming?

In most cases, never. However, there are exceptions to this rule This is normally when they feel you don’t have ‘mental capacity’, i.e., when you may not be able to make certain decisions because they feel you won’t understand the advice, or your physical or mental health is likely to suffer unless you receive treatment or support.

This also applies where there are issues around child protection; when they are worried you may harm yourself more seriously than you meant to; if you’re expressing suicidal feelings; you’re being sexually or physically abused; or your self-harm will lead to permanent damage.

If they do decide to contact someone else, then they should let you know they are going to do that first.

Can a doctor or a therapist tell my parents I’m self-harming?

Parents don’t have an automatic right to know what is said during your treatment with a mental health professional, even if you’re under 16 and if they’ve given permission for you to have the treatment in the first place.

There are some exceptional circumstances when a doctor can disclose information about you without your consent, even if you have mental capacity and are considered ‘competent’. An example of this is if the doctor is concerned that you are going to kill yourself – it wouldn’t necessarily be that they would tell your parents (if they do they must tell you they will do this), but they may talk to another professional such as psychiatrist or social worker.

Will my parents or doctor be told if I go to A&E for self-harm?

If you’ve been to an emergency department because you’ve self-harmed, a very brief letter will go to your GP which states why you came in and what investigations you had. There is a confidentiality policy, but this doesn’t exclude doctors talking to each other where it’s helpful they know about self-harm. If you really object to this then it’s down to the health professional to decide if this should be respected.

What if I tell a teacher I’m self-harming? Will they tell someone?

Teachers have a legal duty not to keep certain things to themselves. If you confide in a teacher, they should refer you to an experienced counsellor or health professional who knows how best to help and support you. “We can’t keep anything confidential in terms of self-harming or abuse, and we do have to refer it,” says Jo, a secondary school teacher. “But it won’t necessarily be to your parents, but within the school, such as the school’s designated Child Protection officer, the school nurse, or the head teacher.”

Someone I know is self-harming, should I tell someone?

This is a tricky one as you don’t want to betray your friend or partner’s trust and right to privacy, but this might not be something you can handle alone, either. The ideal scenario is that they seek further help themselves, but this may not be something they want to do.

You can talk to a GP or counsellor about someone, but they can only help them if the person you are worried about speaks to them directly. Even if you’re a carer, rules of confidentiality still apply. This has led to a ‘Partners in Care’ campaign, which aims to get the laws changed so that carers can access information about patients.

What if I think they’re in danger?

If you’re worried they may hurt themselves badly then it’s best to tell someone. Karen Wright, psychiatric social worker, says: “If your partner’s self-harm could seriously put their health at risk or they are suicidal you may need to be honest and clear that you feel you need to pass information onto their GP or A&E staff to help to keep them safe.” We have more information about coping with someone else’s self-harm here.