Can I go to A&E for self-harm?

If you self-harm and need immediate medical assistance, your nearest Accident and Emergency (A&E) department is the first place to go to. The Mix finds out what happens when you get there.

Trigger warning: This article includes references to self harm.

If you or someone you know is self-harming, it’s important to know when to get help – especially to know when it’s time to go to A&E. The Mix explains what happens when you go to hospital for self-harm.

Visiting A&E

The thought of going to hospital for self-harm can feel intimidating. You might be worried that you’ll be judged by the A&E staff who tend to you, or that you’ll get into trouble – but that’s not the case. You might need to go to the hospital urgently if you’ve been cutting or have taken an overdose. You should go to A&E for self-harm if: 

• Your life is at risk – for example, if you’ve cut yourself badly while self-harming, or have taken an overdose.
• You don’t feel able to keep yourself safe.

The most important thing is that any at-risk person is  kept safe. Hospital staff have special guidelines to help people experiencing a mental health crisis, so are best placed to help you in an environment that is as supportive and comfortable as possible. This means that when you arrive you should be given the same amount of respect, care and compassion as any patient.

What should I do if I’ve overdosed or cut myself badly?

If you’ve taken an overdose, it’s very important to seek medical attention as soon as you can – you could ask a friend or family member to take you to the hospital, or call 999 if you don’t have any way of getting there yourself. 

If you’ve cut yourself whilst self-harming, you can tend to some minor wounds yourself with some simple first aid. But if you’ve hurt yourself badly and are struggling to stop the bleeding, call an ambulance or make your way to the nearest hospital.

“If you’ve taken an overdose you should always go to the emergency department,” says Dr Katie Muscroft, who works in A&E. “If you’ve cut yourself superficially (not fully penetrated the top layer of skin), give your wound a good clean with soapy water. If it’s very deep, you feel it might need stitches, or is bleeding excessively, go directly to A&E.”

What will happen when I get to A&E?

When you get to A&E, the main aim of the nurses who tend to you is to deal with your physical injuries as soon as possible. They’ll carry out what is known as a ‘triage’ assessment, which will determine how critical your physical injuries and state of mind are. These are categorised as ‘minor’ or ‘major’, with the most life-threatening prioritised. You’ll either be directed to a bed or asked to wait in the waiting area.

Emergency treatments for self-harm

The two most common forms of self-injury at A&E are cutting and overdosing – also referred to as ‘self-poisoning’. Each case will be different, but the most likely emergency procedure for these are as follows:

Treatments for cutting

• The doctor will ask what has happened, what you cut yourself with; when, where and why you did this.
• You will be asked if you have a history of mental illness, as the physical injury is only one part of the emergency.
• Your wounds will be cleaned and the doctor will look to see how deep the cuts are. If the wound isn’t very deep and there doesn’t seem to be any nerve or muscle damage, it can be closed with paper stitches or medical glue.
• If the wound is particularly deep, a local anaesthetic to numb the area can be given.
• If there is damage to the nerves and muscles, you may be referred to a specialist, such as an orthopaedic surgeon or plastic surgeon. They may perform an operation, which is usually done the same or following day.

Treatments for self-poisoning and overdosing

Sometimes ambulance staff may need to give you treatment before you reach the emergency department. Depending on individual circumstances:

• The doctor will need to know what you’ve taken, when you’ve taken it and how much.
• Within an hour of taking the overdose you may be given a drink of ‘activated charcoal’ – a black, unpleasant-tasting drink that prevents the stomach from absorbing the poison.
• Blood tests will be taken and paracetamol levels checked. It will depend on the amounts taken as to when you may be treated.
• If there’s evidence to suggest a very large overdose, treatment will start immediately, otherwise they will wait to find out the levels.
• A drip treatment may be given to you via a cannula (a plastic tube inserted into a vein in your arm) and may need to remain in place for up to 24 hours.
• For some overdoses, you may just need observation in the hospital, sometimes for up to 12 hours.

Talking to a doctor about self-harm

When you go to A&E, it might be the first time that you’ve shown another person the extent of your self-harming. It’s important to be honest with the doctor who assesses you, so that they can accurately gauge not only what help you need in that moment, but also what help you might need after they’ve discharged you from hospital.

A doctor will assess your mental and emotional state – this might also be carried out by a duty psychiatrist or psychiatric nurse. You should try to tell them as much as you can about your feelings, and let them know if you’ve been having suicidal thoughts – that way, they’ll be more able to give you the care that you’ll need. 

“You should talk to someone about why you felt the need to cut yourself, and if you want any help,” says Dr Muscroft. “If a professional can help from the start, you can get the help you need as soon as possible.”

Read our article on how to talk to someone about self-harming.

What happens after I’m discharged from hospital?

Unfortunately, A&E units are incredibly busy, and not every hospital will have a social worker or Community Psychiatric Nurse (CPN) to provide you with longer term help with self harm.

When this is the case, the hospital will likely give you contact details for them so that you can get help after you’re discharged from hospital. They can help you stop self-harming and help you to get your life back on track.

If you’re unsure about your mental health treatment plan, or if you haven’t been given one at all, you can speak to our trained team for some friendly advice.