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This Fact Sheet provides an overview of indicators of self-harm and suicide. For supporting someone in a situation of immediate risk of self-harm or suicide, please refer to the Responding to Suicide and Self-harm Fact Sheet or call Emergency Services on 000.
What is self-harm?
Self-harm is an intentional injury to oneself, and can include cutting, burning or hitting, binge-eating or starvation, or repeatedly putting oneself in dangerous situations. It can also involve abuse of drugs or alcohol, including overdosing on prescription medications.
Self-harming is often done in secret and is most common in young people aged 11–25 years, where it is used as a way of coping, particularly where they have not learned or cannot use more helpful coping strategies. Self-harming behaviour can become compulsive and repetitive, and it can be difficult to break the cyclical nature of the behaviour.
What are warning signs of self-harm?
A person that engages in self-harming behaviour, may attempt to cover up their injuries to avoid comments or reactions from others. They may be ashamed, upset or angry if approached about it, even if that is out of concern for their wellbeing.
Some of the warning signs of self-harm include:
- Injuries that are unexplained
- Covering parts of the body, e.g. wearing long clothing even in hot weather
- Avoidance of situations where parts of their body would be exposed
- Changes to mood
- Low self esteem
- Withdrawal from family or peers
- Substance misuse
Reasons for self-harm
People who self-harm may do so for various reasons, including to:
- Deal with or stop negative emotions or pain such as feeling hopeless, anxious or rejected
- Release tension or a build-up of emotions
- Relieve feelings of loneliness or isolation
- Punish themselves for something they have done or something they perceived as their fault
- Feel ‘alive’ or ‘real’, or to combat feelings of numbness
- Feel more in control of their life
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- Communicate to people that they need some support when they feel unable to use words.
A person who self-harms may not necessarily intend to end their life; however, the consequences of their risky behaviour can be fatal, and it needs careful assessment and care by a health professional.
What is suicide?
Suicide is undertaken with the intent by a person to end their own life.
Reasons for suicide
The reasons why a person thinks about suicide is varied and personal. Often, it is because of a combination of factors related to their feelings or thoughts, or they may have recently experienced a ‘triggering’ event.
A person thinking about suicide may feel:
- like suicide is their only way out
- alone, isolated and disconnected from the world around them
- helpless
- an unbearable amount of pain
- that no one understands them or that they are a burden
- that nothing will change to improve their situation.
Some ‘triggering’ factors that may cause someone to consider suicide include:
- relationship break downs
- recent loss (a loved one, job, relationship, pet or public figure)
- family problems
- physical illness or injury
- sexual, physical or emotional abuse
- drug or alcohol problems
- mental illness, including schizophrenia, bipolar disorder and depression
- eating disorders
- school, higher education or work problems
- unemployment or being unemployed for a long time
- feeling like they don’t belong anywhere
- financial or legal problems
- major disappointments
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- change in circumstances (retirement, separation, children leaving home).
What are suicide warning signs?
A person who is thinking about suicide will usually give some clues or signs to those around them that indicate they are distressed or overwhelmed. These are often referred to as suicide warning signs and may include physical changes, behaviour, verbal statements, and feelings.
Suicide prevention starts with recognising these suicide warning signs and taking them seriously.
The following is a list of warning signs that a person may display which may indicate they might be thinking about suicide. It is most likely that a person considering suicide will display a combination of these signs rather than one single sign.
Physical changes
- Loss of physical energy
- Loss of interest in personal hygiene or appearance
- Major changes to sleeping patterns, too much or too little
- Loss of interest in sex
- Sudden and extreme changes in eating habits, either loss of appetite or increase in appetite
- Weight gain or loss
- Increase in minor illnesses
Behaviours
- Prior suicide attempts
- Unexplained crying
- Emotional outbursts
- Alcohol or drug misuse
- Uncharacteristic risk-taking or recklessness (for example, driving recklessly)
- Fighting and/or breaking the law
- Withdrawal from family and friends
- Quitting activities that were previously important
- Self-harming
- Putting affairs in order e.g. giving away possessions, especially those that have special significance for the person
- Writing a suicide note or goodbye letters to people
Conversational signs
- Escape: “I can’t take this anymore.”
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- No future: “What’s the point? Things are never going to get any better.”
- Guilt: “It’s all my fault, I’m to blame”
- Alone: “I’m on my own, no-one cares about me.”
- Damaged: “I’ve been irreparably damaged”, “I’ll never be the same again.”
- Helpless: “Nothing I do makes a bit of difference”, “It’s beyond my control.”
- Talking about suicide or death
- Planning for suicide
Feelings
- Desperation
- Sadness
- Anger
- Shame
- Worthlessness
- Powerlessness
- Loneliness
- Isolation
- Disconnection
- Hopelessness
High risk groups
Suicide and self-harm can affect people of all ages (except very young children), races, ethnicities, sexual orientations and occupations. However, a number of subgroups are at higher risk due to many factors.
The factors effecting high risk groups can be poor mental health outcomes due to multiple factors including inaccessibility of high quality mental health care services, cultural stigma surrounding mental health care, discrimination, and overall lack of awareness about mental health.
Understanding differences in numbers and rates of suicide, intentional self-harm and suicidal behaviours in these populations is essential for more effective suicide prevention.
- people with physical illness
- people with a history of suicide related behaviour or self-harm
- people with mental illness
- Indigenous populations
- men
- people with substance misuse problems
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- rural and remote populations
- youth
- people who have been bereaved by suicide
- people engaged with the justice system
- lesbian, gay, bisexual and transgender and intersex (LGBTI) populations
- Culturally and Linguistically Diverse (CALD) populations
- older adults
- people who are divorced, widowed, separated or single
- people who are unemployed or with low socioeconomic status
- people who are socially isolated or who lack social support
TASC Model for talking with someone at risk of suicide
The following model can be used when you are concerned that someone might be considering suicide.
- T – Tune-in to the possibility of suicide – are they suggesting they want to end everything, or that it’s all too much?
- A – Ask “are you thinking about suicide?” – be specific and don’t hesitate to ask the question.
- S – State that suicide is serious – let them know that you’ve heard them and take it seriously.
- C – Connect to help – provide them with a list of resources for who they can contact, or do it for them.
This model is based on the LivingWorks Start model. LivingWorks Australia is a suicide intervention training company.
Getting help
Whether a person is engaging in self-harming behaviour or considering suicide, talk about steps you can take together to keep the person safe. Don’t agree to keep their self-harming behaviour or suicide thoughts a secret, and don’t shoulder the situation yourself. You can also help by finding out information on what resources and services are available for a person who is self-harming or considering suicide. Provide the person a list of emergency numbers in case they need it later.
In some situations a person might refuse help and you may need help from someone else to assist them to get help. In these cases, ensure the appropriate people (for example, emergency contact, GP, mental health specialist) are aware of the situation to ensure follow up support is in place. Never leave a person at immediate risk of suicide alone. If the person is unable to stay safe you may have to contact professional help against their wishes, but talk to them about this first if possible.
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Make a Safety Plan even if they’re okay
A safety plan brings together someone’s coping strategies into a series of steps. Research has shown having a safety plan can be useful for reducing the intensity of suicidal thoughts and increasing people’s ability to cope with them.
Encourage the person to speak to their GP or other qualified practitioner to make a safety plan, using resources such as the Beyond Now app or on the Beyond Blue Beyond Now Safety Plan website.
This should be done only by a qualified professional, but workers may advise the person of this option.
Supporting someone returning to work
Someone returning to work after a suicide attempt or self-harming may feel isolated and alone. Any genuine care and concern that you can offer could make a real difference, helping them to feel connected.
They may or may not want to talk about what has happened and it is important to respect their choice, but you can still make it clear you’re there for them if they do want to talk about it.
If you are the person’s manager, talk with your HR Business Partner or the Workplace Supports team on how best to support them. You don’t need to breach confidentiality.
Self-care
Supporting a person who is engaging in self-harming behaviour, is suicidal, has attempted suicide, or is bereaved by suicide, can generate a broad range of feelings. It can be confusing, stressful and overwhelming. As with any other time of stress it is essential that you look after yourself emotionally and physically. Staying connected with your friends and family should also be a priority.
You can:
- Develop a support network for yourself – continue to catch up with friends, family or other important people in your life.
- Prioritise your own needs. Look to include activities you enjoy in your normal routine.
- Reduce consumption of alcohol and other drugs which may only mask your feelings.
- Establish a good sleep pattern.
- Spend lots of time outdoors in nature and continue to exercise and nourish your body with healthy foods.
- Build relaxation into your routine – breathing exercises, yoga and meditation can be helpful.
- Access support services. Supporting someone who is suicidal can be traumatic. It’s important to talk about it and not ignore how you’re feeling.
Emergency Support Services
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| Organisation | Service | Contact Details |
|---|---|---|
| Emergency Services | If you think someone is in immediate danger, call emergency services. | Phone: 000 |
| Lifeline | - Crisis support and Suicide prevention services - Contact 24 hours 7 days a week - Lifeline Crisis Chat is available 24/7 |
Phone: 13 11 14 Text: 0477 131 114 |
| Suicide Call Back Service | Nationwide service that provides professional 24/7 telephone and online counselling to people affected by suicide. | Phone: 1300 659 467 |
| Beyond Blue | - Call 24/7 - Chat online 3pm-12am / 7 days - Email — get a response within 24 hours |
Phone: 1300 224 636 |
| APS Employees Benestar | Employee Assistance Program (EAP) | Phone: 1300 360 364 |
| Labour Hire EAP | Employee Assistance Program (EAP) | EAP providers for Labour Hire Workers (DOCX 81KB) |
Additonal supports and learning
Compassionate Foundations training through APS Academy (external)
After a suicide attempt (beyondblue.org.au)
Have you lost someone to suicide? Factsheet (Lifeline.org,au)
This Guide has been written with resources from Living Works, Suicide Call Back Service, Beyond Blue, Heads Up and Suicide.org.
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Document Control
| Document No | NDIA-WHS-FAC-029-001-FINAL Understanding Suicide and Self Harm Fact Sheet |
|---|---|
| HPECM Document No | |
| Date | August 2022 |
| Status | FINAL |
| Version | 002 |
| Document applicability | National |
| Owner | Work Health and Safety Team |
Approval Status Log
| Version | 1 |
|---|---|
| Reviewed by | P&C Division - Work Health and Safety team, Mental Health team, HR Advisory team. |
| Endorsed by | Director, WHS & Wellbeing team |
| Approved by | Director, WHS & Wellbeing team |
| Approval date | 10/08/2022 |
Revision History
| Revision | Date | Sections | Summary of Changes |
|---|---|---|---|
| 1 | 12/2020 | All | Uploaded onto template |
| 2 | 8/2022 | Sections | Emergency Supports / Self Care and High Risk Groups. |
Note: Document uncontrolled in hardcopy
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