Self Harm Signs and Risk Factors Checklist

This checklist is designed to determine behaviours that may indicate a patient is engaging in some form of self harm. The results must be interpreted in the context of an individual’s circumstances and as such should be used only in combination with a comprehensive medical and clinical assessment. It is NOT a stand-alone diagnostic tool.

Psychological signs

  • Obvious changes in mood
  • Changes in sleeping and eating patterns
  • Losing interest and pleasure in activities they once enjoyed
  • Withdrawal from and poor communication with friends and family
  • Hiding or washing their own clothes and avoiding situations were exposure of arm and legs is required (e.g. swimming)
  • Problems in social or intimate relationships
  • Strange excuses provided for injuries
  • Problems with work, school, social or family life

Physical signs

  • Unexplained injuries, such as scratches, cuts or burn marks
  • Unexplained physical complaints such as headaches or stomach pains
  • Wearing clothes that cover up arms and legs, even in hot weather

Risk factors

  • History of self-harm and/or previous suicide attempt
  • Mental or substance use disorders, especially depression
  • Physical illness: terminal, painful or debilitating illness
  • Family history of suicide, substance abuse and/or other psychiatric disorders
  • History of sexual, physical or emotional abuse
  • Socially isolated or living alone
  • Bereavement in childhood
  • Family disturbances
  • Unemployment, change in occupational or financial status
  • Rejection by a significant person (e.g. relationship breakup)
  • Recent discharge from a psychiatric facility

If a patient’s presentation meets 1 or more criteria from each of the above categories, there is an increased chance that they are engaging in self-harm behaviours. In this case, it is important to complete a thorough suicide risk assessment at the time of your consultation.

It is also recommended that they be referred to a psychologist for a more comprehensive assessment. To book an appointment with a psychologist, contact Strategic Psychology on (02) 6262 6157 or email


Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, D.C.: American Psychiatric Association.