Self-harm strategy and action plan: mid-term report

Wider Policy Update and Strategic Context

The Self-Harm Strategy continues to be a vital component of Scotland’s broader commitment to improving mental health and wellbeing across the population. As the strategy reaches its mid-term point, it is essential to consider its progress within the wider landscape of connected policies and programmes that collectively seek to address the complex social determinants and risk factors which are associated with self-harm.

The following information sets out the key policies and context which relate to the delivery of the Self-Harm Strategy.

Alignment and Integration with the Mental Health and Wellbeing Strategy

The Self-Harm Strategy’s outcomes and vision are very closely aligned with the overarching Mental Health and Wellbeing Strategy, where it is recognised that this wider work has the potential to impact self-harm, for example through progressing actions around the social determinants that impact on mental health and in turn self-harm. Learning from the interim report on the Mental Health and Wellbeing Strategy notes its successes to date which may impact self-harm as well as highlighting key challenges of funding and capacity within the system, progress on the Self-Harm Strategy is being sought with the same challenging landscape. This recognises the close relationship between mental health and self-harm, with both strategies needed to support population wide mental health in its broadest sense - and people affected by self-harm more specifically.

To ensure our Mental Health and Wellbeing and Self-Harm Strategies work together, we have aligned the reporting mechanisms for our self-harm work to the Mental Health and Wellbeing Leadership Board, including presenting the learning from this report to Board members. We want to see joined-up consideration of the implementation of the Self-Harm Action Plan, including the wide range of supporting coordinated action across strategies and sectors. Strengthening these connections, and focusing on social determinants, will be critical to achieving long-term improvements in mental health and wellbeing across Scotland.

Suicide Prevention

Whilst self-harm does not always indicate suicidal intent, it remains one of the main risk factors and predictors for suicide. As such, the Self-Harm Strategy supports and complements the Scottish Government and COSLA’s Suicide Prevention Strategy, ‘Creating Hope Together’. In practice, the implementation teams for both strategies collaborate on areas where the needs of people who are in suicidal crisis and / or have self-harmed are overlapping and where the work to drive change is the same. We also collaborate with many of the same partners, including See Me, NHS Education Scotland (NES) and Public Health Scotland (PHS).

Our strategy recognises that many types of behaviours can be considered a form of self-harm. This includes health harming behaviours such as substance use, eating disorders and gambling related harms. As these areas are increasingly acknowledged as interconnected with self-harm, it is vital that work continues to raise awareness of self-harm, in its various presentations and that support is available to people who might not have considered their behaviour as a form of self-harm previously. Work will also continue to ensure national and local policies, are integrated and take a multi-agency approach.

Workforce Development and Support

The mental health and wellbeing workforce plays a vital role in delivering the strategy’s ambitions. Supporting this, the ongoing implementation of the Workforce Action Plan, is helping to build capacity, strengthen skills, and foster resilience across sectors. A wide range of training programmes are now available to support improve awareness and responses to self-harm. Including those developed and delivered by Self-Harm Network Scotland (SHNS) as part of our action plan and broader workforce development initiatives led by NHS Education for Scotland (NES). Together, these programmes work towards ensuring that professionals across health and social care, local authorities, and the third sector are equipped to provide compassionate, recovery-focused support. In the next iteration of the Mental Health and Wellbeing Delivery Plan, the workforce action plan will be integrated within the Delivery Plan to ensure more aligned and strategic approach to workforce development.

Legislative Environment: Online Safety Act 2023

The digital landscape presents both risks and opportunities for self-harm support and intervention. The recently enacted Online Safety Act 2023 plays a crucial role in protecting vulnerable individuals from harmful online content and facilitating safer digital environments. The Scottish Government sought, and received, the Scottish Parliament’s consent to apply the new offence of encouraging and assisting self-harm in Scotland. This offence came into force in January 2024 and now serves as both as a deterrent against harmful or malicious communication, whether online or in-person, and as a legal mechanism to prosecute offenders.

As such, the Online Safety Act overall - and the new offence of encouraging and assisting others to self-harm in particular - helps to deliver the Strategy’s vision of improving responses and support for people who self-harm.

Funding

The strategy’s implementation is supported by continued investment from the Scottish Government of over £2.2 million since 2021. This primarily funds a range of free services and training provided by Self-Harm Network Scotland (SHNS), as well as the suite of wider actions set out in the strategy. The allocation of a further £1.5 million between 2025-27 to SHNS under the Fairer Funding pilot supports financial stability and allows long-term planning for this element of delivery for the remaining span of the strategy.