Here at SelfharmUK we want to help people understand their harming behaviour and explore other ways to cope with life's challenges.

If you get in touch we'll listen to your story and suggest ways to help you move forward ... but somewhere along the line we'll almost always suggest you visit your GP.  This can be a really tough thing to do, we know it can be scary, and can mean having to tell your parents too (though not always) but we believe it can be a significant step towards feeling better.

We asked GP David Roberts what you can expect when talking to your doctor about self-harm and whilst this article is only a guide - and not a definitive set of facts - we hope it will help you feel more in control, if and when, you walk into that consulting room...

Why do I have to go to the Doctor?

Self-harming is usually an indication that all is not right. People sometimes do it because it relieves internal tension and stress. It is not a very good way of doing this and like drugs, alcohol and smoking ultimately doesn't do any good. But in the short term it gives a temporary relief from emotional pain. However, it can be a symptom of a more serious mental illness and so your doctor can make sure you get the help you need.

Can I go on my own or do I have to take a parent?

You can legally go to the GP alone aged 16, but doctors can accept that you may be able to make your own decisions about your health (eg contraception) from 14 if they think you understand things and are mature enough to do so. A doctor would want you to involve your parent(s) in your care until you are 16 and are likely to encourage you. They would not give you an injection or carry out an operation, or even do an intimate (embarrassing) examination (physical check) without your parent's permission before you are 16.

How can I get ready for my appointment?

Even if you are under 16 That does not mean that you cannot talk to them about your problems or issues. It is a good idea to think about what you want to say and write the main points down. Lots of people get embarrassed at what they want to say and so don't get to the point. Doctors are busy and don't get embarrassed by what you think or say, so it is better to take a deep breath and say it right at the beginning rather than put it off. They won't mind and it will give them more time to talk to you than if you spend the first five minutes talking about a rash that no one can see because it really isn't there!  Think about what you want to get out of the appointment - do you just want to tell someone and get it off your chest, do you want help stopping it, do you want them to refer you on to someone who could give you specialist help? If you tell them what you want then they can work out how best to support you.

What will happen if I say I self harm?

Self harming is quite common and they will have seen other people who do it. So they won't be shocked, but they will be concerned. The biggest concern they would have is that you might want to kill yourself. Not many people who self harm want to do this but doctors have a professional duty to assess the risk of that happening. they are obliged to keep what you say confidential and private between you and them, unless you tell them something that they think might indicate that your health is seriously at risk (or you might be planning to do something that might endanger someone else) - see later - in which case they may be obliged to break your confidence. They should tell you this. They will want to help you, and so if you have plucked up courage to tell them, they will try to find ways to do that.

What will they ask me?

This might include asking some deep questions which you might find embarrassing: don't be though, they're only trying to work out what's making you do this. They'll ask about cutting, taking drugs, overdoses, and other ways you might be tempted to hurt yourself. They may ask you about how you feel (low, depressed, crying, worried, frightened, angry) and how things are at home or school or work.  If they feel you trust them they might ask you to come back again to see them, and they might suggest that they refer you on to see a specialist from the CAMH service (people who work most of their time with young people with similar problems). They might encourage you to speak to a counsellor at school, particularly if there is someone there you feel you can talk to. They will want to know why you have come to see them at that time and to find out what help you want them to give you. You may not be able to say this, but if you've thought about it beforehand it will help.

Do they have to tell my parents?

They are obliged in law to protect you and others from actions you might take that might harm you or others. But they need to check how likely your might be to do something you say you want to do so they will question you quite hard. If you are under 16 and they think you are suicidal (or planning a murder!) they will have to tell your parents or other authorities. They will still encourage you to involve your parents as they have legal responsibility for you, but if the risk is low in their view, they will try their best to keep what you say confidential.

Will I have to show them where I have self-harmed?

They can't and won't force you (unless they are seriously worried about you being in danger and even then they will ask for advice from someone who specialises in child protection). They will want to assess how bad your injuries are - you might need antibiotics if your cuts are infected, and you might need dressings to protect the wounds.

Remember they aren't easily shocked or embarrassed and really want to help you - showing them the extent of your cutting will help them work out how serious the problem is and how to get you the best help.

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