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The Royal College of Psychiatrists Improving the lives of people with mental illness

CR192. Managing self-harm in young people

Price: £0.00

Approved: Jun 2014

Published: Oct 2014

Status: current

Number of pages: 30

Review by: 2019

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This report is only available online – there are no printed copies available to buy.

Please use the link above to view and download a PDF file of the report.

Suicide remains the second most common cause of death among young people. Self-harm is an important signal of distress, so it needs sensitive responses with careful handling. Our actions are important. Our actions can make a difference for young people and turn lives around. Our actions can save lives.


This report has been written by psychiatrists, but it is intended for a broad readership. As evidenced in the consultation process, opinions of many other professional groups have been included. The endorsements by YoungMinds, the Royal College of Paediatrics and Child Health and the Royal College of Nursing provide firm evidence of this. The intended readership is mainly professionals working with young people, although young people and families may also find the report useful, particularly in understanding how services should work together.


As there is much written on the subject of self-harm, this report does not attempt to cover all areas of management. It focuses on service-level issues, particularly the roles of professionals and interservice relationships.


Fourteen recommendations are highlighted throughout the report. There are additional good practice points included throughout the text. Some key focuses include: courage and compassion in asking about self-harm, from community to hospital settings; reduction of stigma and the importance of treating young people who have self-harmed in a non-judgemental and respectful manner; high-quality assessment at all levels of service.


One key recommendation relates to admission of 16- and 17-year olds attending acute hospital. The report recommends that routine admission is not expected, but if there is doubt about the safety of the young person, the arrangement or the quality of assessment, then admission to an acute hospital is to follow.


Patterns of self-harm in children and young people are evolving with the explosion of digital communication. Our understanding of the impact of this revolution in communication is growing. We have included a section at the end of the report summarising positive and negative aspects of the online world and some tips for professionals and parents.


This report replaces CR64: Managing Deliberate Self Harm in Young People from 1998.


  • Acknowledgements
  • Executive summary
  • Background
  • Commissioning services
  • Risk factors
  • Young people’s experiences of services
  • Community presentation of self-harm
  • Assessment and interventions for acute presentation to hospital
  • Joint protocols for the management of self-harm
  • Acute presentation to hospital: roles and responsibilities of involved staff
  • Liaison services for acute presentations to hospital
  • Self-harm and the internet
  • Appendix of online resources
  • References
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