Please visit our dedicated family, friends, and carers webpage if you are concerned about the safety or wellbeing of an adult with care and support needs, or if you would just like to know more about adult safeguarding and the work of the Safeguarding Adults Board.
If you are concerned that an adult who is self-harming and experiencing or at risk of abuse, you can make a safeguarding referral using the West Sussex County Council online safeguarding referral form.
For mental health support including for self-harm see Getting help with your mental health | Sussex Partnership NHS Foundation Trust.
The National Institute for Health and Care Excellence (NICE 2024) describes self-harm as “Intentional self-poisoning or injury, irrespective of the apparent purpose."
The Care Act 2014 safeguarding criteria relates to those adults with care and support needs, who are at risk of, or experiencing, abuse or neglect, and as a result of their care and support needs, are unable to protect themselves.
Whilst the Care Act doesn’t reference self-harm as a category for safeguarding, we know that concerns around self-harm can, and do, co-occur with concerns around abuse and neglect that are covered under the Care Act. This means that, whilst self-harm does not indicate a safeguarding concern on its own, self-harm may be a factor in safeguarding cases. Therefore, it’s important that professionals are aware of the signs and risk factors for self-harm, and how to access support for adults engaging in or at risk of self-harming behaviour; both for those who meet the Care Act criteria for safeguarding, and those who sit outside of it.
It is a common misconception that self-harm meets the criteria for safeguarding under the broader umbrella of self-neglect. However, that is not the case. Self-harm is an intentional act, to inflict pain as a way of managing emotions. This is different to self-neglect, where pain or suffering may be an indirect result of self-neglect actions.
Where professionals feel that self-harming actions are as a result of abuse or neglect by a third party, it may be appropriate to refer a safeguarding concern to the local authority. But a safeguarding referral will rarely be the most appropriate response to self-harming concerns.
Self-harm is a risk factor for suicide. People who have self-harmed are at greatly increased risk of suicide (NICE 2022). Whilst self-harm on its own does not indicate a safeguarding concern, the national suicide prevention strategy and West Sussex Suicide Prevention Framework and Action plan (PDF, 1MB) outlines those who have self-harmed as a priority group for support to prevent suicide. Therefore, active encouragement and signposting to support is essential in preventing suicide in people who are self-harming.
Self-harm can be experienced by anybody at any time, and there isn’t always an obvious trigger. However, there are some life events or challenges which can make it more difficult for people to cope, and which may lead people to engage in self-harming acts as a way of dealing with difficult feelings. These may include:
This list is not exhaustive, but being faced with any of these challenges, can make it more difficult to cope.
Self-harm can take many forms, and is characterised by a deliberate act to inflict pain (usually physical, but can also be emotional), as a way to manage difficult feelings. This can include (but is not limited to):
If at any point a person is at immediate risk of harm to themselves or others you should contact 999 for assistance. As long as it does not place you in any danger, do not leave them alone.
If you are concerned that somebody you are working with is self-harming, you can encourage them to seek support from their GP surgery, or from a confidential listening service, such as the Samaritans. It’s important to ensure that you listen to their thoughts and feelings without judgement, and to consider that the self-harm may be an indicator of distress, rather than the whole picture. If you can, encourage them to talk to you about anything that may be triggering their self-harm (but understand that in some cases, there is no single trigger and/or the person may not have insight into their triggers).
Whilst you can talk to them about alternative coping strategies, it is important that you don’t encourage them to stop. For many people who engage in self-harm, the self-harm provides an outlet for difficult feelings. If you remove that outlet without replacing it with something else, there is a danger that they may take even riskier actions to cope with their distress.
If the adult is known to adult social care or mental health services, you can encourage them to reach out to them for more support. However, it’s important to remember that self-harm in isolation or without concerns of abuse is not a safeguarding issue and therefore the local authority is unlikely to be an effective route for accessing support for the individual. If you are concerned that an adult who is self-harming and experiencing or at risk of abuse, you can make a safeguarding referral using the West Sussex County Council online safeguarding referral form.
For mental health support including for self-harm see Getting help with your mental health | Sussex Partnership NHS Foundation Trust.
Harmless (2025) People that Self Harm
Mind (2025) Treatment and support for self-harm
NHS (2025) Self-harm
Samaritans (2025) If you’re worried about someone else
