Secure online form - Self Harm - Out Of the other areas

This form will enable you to refer into the Harmless self-harm service. Whether you need help for yourself or for someone else, Harmless’ dedicated self harm support team are dedicated to supporting those who need our help.
Please note: We have temporarily suspended out of area referrals due to pressures on the service and not bring funded for this provision. Should you wish to leave details of where you are located so we can monitor demand within your local area to support future funding applications, please do so by emailing us at
We are not currently funded to provide out of area support, however we can assist in identifying services local to you that may be able to help.
On receiving your referral the individual can expect a response up to 4 weeks, if for any reason this does not happen then please do not hesitate to contact our service on 01158800280 or
Contact At Home?

Referral Source

GP Details