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

Next Steps

As we move forward toward the next 18 months of this Action Plan, we will be increasing our focus on delivering the medium-term outcomes of the strategy. The following section sets out additional detail on our areas of focus to help increase the impact of our work over the remainder of this action plan. Within this, we have sought to update and focus our attention on actions which build on and address gaps within the current Action Plan. This is intended to demonstrate where our work will focus on for the next 18 months whilst still continuing to make progress across the wider Action Plan.

Medium - Term Outcomes

1: People with a role in supporting individuals affected by self-harm across a range of settings and services, are more skilled and confident in providing effective, compassionate and non-stigmatising support

2: More people who self-harm, or who are supporting someone who self-harms, can access effective, compassionate and non-stigmatising support across a range of new and existing services.

3: More people who self-harm are supported to develop alternative ways to cope and are supported in their recovery.

4: Effective, compassionate and non-stigmatising responses to self-harm are increasingly embedded across policy and practice in existing and new services and settings.

5: A strategic approach is taken to improving and enhancing self-harm data collection.

6: Best practice, evidence and learning from relevant data, evidence and research is disseminated and incorporated into practice.

Vision

Our vision is for people who self-harm or are thinking of self-harm, to receive compassionate, recovery focused support without fear of stigma or discrimination.

Priority 1

We know that misunderstanding, stigma and discrimination continue to shape how self-harm is perceived, responded to, and supported across Scotland. Over the past 18 months, our engagement with people with lived experience, practitioners, and partners has reinforced two key insights. First, that there is a significant demand from communities, services and sectors to increase their understanding of self-harm which is grounded in empathy and evidence. This can transform how individuals and services respond. Second, that stigma, whether internalised, interpersonal, or systemic, remains a significant barrier to compassionate and effective support. To make meaningful progress, we must not only continue to embed learning and awareness in the places where people live, work, and seek help, but also evaluate the impact of this awareness raising in reducing stigma. That’s why we are committed ensuring that training and resources lead to real-world improvements in attitudes, behaviours, and outcomes for people who self-harm.

To progress this we will:

• Further promote the embedding of awareness and resources in key operational settings, including Secure and Residential Care settings, Scottish Ambulance Service, Police Scotland, Parenting programmes.
• Build on the Self-Harm Network Scotland Self-Harm Awareness Training by rolling out a Training for Trainers (T4T) programme to upskill staff and volunteers who work with communities affected by self-harm.
• Self-Harm Network Scotland will contribute to a resource Scottish Ambulance Service are creating that ambulance staff can use to support people who are self-harming, as well as provide training to call handlers and first responders.
• Roll-out bespoke Self-Harm Network Scotland training for trainers and associated materials with staff across the Scottish Prison Service (SPS) and gather feedback to ensure the content and resources are appropriate and relevant to the diverse roles within SPS.
• Self-Harm Network Scotland will continue to tailor and target learning resources, so they meet the needs of specific groups at higher risk of self-harm. This will include an initial focus on neurodivergent and LGBT+ communities. These will be co-developed alongside national and local organisations working in these communities, and importantly with people with lived experience.
• Work with the SHAPE group and wider partners to take a deeper dive into stigma, discrimination and minority stress with a particular focus on how they can present and impact differently depending on settings and experiences with a view to supporting services to provide compassionate responses.
• Work with a range of education and academic stakeholders to further articulate the roles across the education workforce in providing support for children and young people affected by self-harm and what, if any, additional resources and support are required.

Priority 2

People who have self-harmed come from diverse backgrounds and experiences, and their needs vary depending on the circumstances they face and the communities they belong to. Over the past 18 months, our work has reinforced the importance of recognising and responding to this diversity. While some services and settings are beginning to implement compassionate approaches such as those laid out in the Time Space Compassion guide others still face challenges.

To make meaningful progress, we must continue to build capacity across sectors, ensuring that responses to self-harm are not only informed and compassionate, but also person-centred and inclusive. This includes creating opportunities for collaboration, co-production, and knowledge-sharing across professional boundaries. It also means listening closely to people with lived and living experience to understand what support looks like, and how it can be improved.

To progress this we will:

• Work with Self-Harm Network Scotland to deliver our first ever self-harm conference shaped by Scotland’s dedicated strategy and action plan in autumn 2025.
• Support GP practices and Accident and Emergency departments to continue to embed and improve on provide compassionate, non-stigmatising responses to people who self-harm.
• Develop a resource for locality partners, including Local Government, NHS boards and Health and Social Care partnerships, and third sector organisations to support them to consider how they could further implement the relevant actions from Self-Harm Strategy in their local settings.
• Utilise connections made through the Provider Network to create a group of professionals’ working with people who engage in health-harming behaviours that may also be considered forms of self-harm. This group will explore opportunities to strengthen cross-sector connections, share best practice, and enhance coordinated support across services.
• Work with people with lived and living experience of self-harm to explore what is needed around physical and mental health care and support after self-harm, including longer term support.
• Work with the National Risk Management Improvement Group, led by Suicide Prevention Scotland, to ensure self-harm is centred within the collection of new and existing resources, including a new national learning resource on risk formulation skills, to be shared with Scottish NHS Boards and services.

Priority 3

We recognise there are many challenges and gaps in data and evidence across topics focused on and relating to self-harm. Our work with partners across Scotland over the past 18 months has taught us two key points. Firstly, whilst gaps in evidence are widespread, helpful data does exist across different agencies and services. Secondly, even when data is more complete, there are a multitude of ways in which self-harm is perceived, realised, supported, and discriminated against, which affects what evidence is captured. These challenges mean that a well-considered and evidenced plan is needed to improve our data and evidence base, and in turn to improve responses for people affected by self-harm.

To progress this, we will:

• Work with partners to better understand the range of existing self-harm data available with a focus on:
  • Considering strengths, weaknesses/limitations, and any observed changes in the data
  • Looking across a range of settings, including justice, education, and third sector sources.
• Build on the findings from the Barriers report to explore how different groups experience barriers to accessing support for self-harm, so we can focus on improving the inclusivity and cultural sensitivity of services.
• Improve Self-Harm Network Scotland evaluation data collection and follow-up evaluation for supported people and those undertaking self-harm awareness training to improve our understanding of changes in the landscape around self-harm support and awareness. This will include working with the University of Edinburgh, to explore the impact of self-harm awareness training in tackling self-harm-related stigma.
• Develop a dedicated public facing webpage or resource hub to share up-to-date information, research, and practical resources on self-harm with practitioners, service providers, and other relevant partners.
• Explore areas where there are significant gaps or conflicting evidence (for example the role of social contagion) to inform wider work.
• Improve our understanding of how wider services can support compassionate responses to self-harm. Starting with a review into the effectiveness of DBI for people experiencing self-harm, to inform service improvements. This recognises that 9% of Distress Brief Intervention referrals have self-harm behaviour as a presenting problem.