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Table 4 Statements accepted as mental health first aid guidelines

From: Development of mental health first aid guidelines for deliberate non-suicidal self-injury: A Delphi study

Item: Round:
Section 1: If the first aider has interrupted someone who is in the process of injuring themselves....  
... they should express their concern. 1
... they should ask whether they can do anything to alleviate the distress. 1
... they should remain calm, and avoid expressions of shock or anger. 1
... they should ask whether any medical attention is needed. 1
... they should intervene in a supportive and non-judgemental way. 1
If the person has harmed themselves by taking an overdose of medication or consuming poison, the first aider should call an ambulance as the risk of permanent harm or death is high. 1
Section 2: If the first aider suspects someone has been injuring themselves  
The first aider should try to avoid a strong negative reaction to the self-injury and discuss it calmly with the person. 1
The first aider should not ignore the injuries, instead acknowledging to the person that they have noticed them. 1
The first aider should not ask the person about self-injury until they have reflected on their own state of mind and are sure they are prepared to calmly deal with the answer. 1
The first aider should understand that self-injury is a coping mechanism. 1
The first aider should avoid taking a punitive stance such as threatening the withdrawal of care. 1
The first aider shouldn't trivialise the feeling or situations which have led to the self-injury. 2
Section 3: Avoiding self-injury  
The first aider should keep in mind that 'stopping self-injury' should not be the focus, but look at ways to relieve the distress. 1
The first aider should encourage the person to speak to someone they trust next time they feel the urge to self-injury. 1
Section 4: Harm minimisation  
The first aider should ensure that adequate first aid supplies are accessible to the person. 1
Section 5: Professional help  
The first aider should encourage the person to seek professional help. 1
The first aider should only seek professional mental health care if the self-injurious behaviour is having an impact on the person's normal functioning (such as the ability to attend school or go to work). 1
The first aider should call an ambulance regardless of the person's wishes if the injury is life-threatening, such as arterial bleeding. 1