Self-Harm Reporting Card

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Reporting Card: Instant Download

You can still use the card if you have not self-injured but feel you are at risk of harming yourself. You do not need to complete all the questions!

Download Reporting Card For Decorative Purposes Only

Supporting conversations about self-harm and emotional distress.

Utilising tools to support both yourself and those who may be struggling is helpful in ensuring we give the right support at the right time. 


Encouraging people to talk about self-injury can be difficult. 

Not everyone finds it easy to talk about these things. We know that people don’t always disclose to professionals, whose role it is to discuss self injury. We also know that some professionals might need information from those who self-injure to get to the thoughts and feelings which lie behind self-injury behaviours.

Lancashire Mind co-produced the self-harm report card and supporting posters with young people and professionals to support those who self-injure to have helpful and empowering conversation about self-injury behaviours and emotional distress.  

How to use the reporting card

If you are having difficulty downloading the card you may need to install a PDF reader onto your device, there are many free pdf reader apps you can download from your app store.
Or you can collect a paper copy from the room listed on the poster you are reading.
When you have completed the card, please take you can take your phone to one of the named members of staff, your pastoral team, or a trusted adult or professional. You can show them the card on your phone, and they will talk with you about support.  The card aims to support you to have difficult conversations.
Once you have used the card just delete the download file from your device. Completing the card will not automatically notify someone of your distress. We do not collect any contact or user information. This is for your personal use only. *Lancashire Mind does not collect any data that could identify individuals downloading this form and cannot view any information you input into it. After you have used the card to seek support, you can delete it from your device and any cloud-based storage or you can keep it for your own reference. This form is for personal use only, Lancashire Mind is not responsible for the use of this card or who it is shared with.

Overview and user guide.

Reporting a self-harm related injury or seeking support for self-harm behavior can be difficult to vocalise for children and young people. This self-harm reporting card was co created by professionals working with young people who self-injure and young people. Creating a card with young people for young people ensures the card includes the questions that young people feel would be most beneficial when seeking support for thoughts of self-harm or treatment for self-harm related injuries.

Derived from medical treatment cards currently available, this digital self-harm report card has been developed to be young person centred and can enable young people to seek support without needing to put the information into words and to make conversations easier.

By displaying our posters promoting the self-harm report card in private areas of a school, organisation or venue, such as changing rooms and toilet cubicles, young people can scan the QR code using their mobile phone.

This will enable them to download a fillable PDF and complete the card as a communication tool between a trusted professional/adult and a young person around self-injury behaviour and difficult thoughts and feelings. The card enables the young person to share the following information:

  • The young person’s name.
  • If they have taken an overdose and if so what and how much.
  • If they have self-injured.
  • Space to provide details of the injury or if they are feeling like they want to self-injure
  • If they have drunk alcohol.
  • How they were/are feeling.
  • What they feel may have triggered this incident or feelings.

Once completed, young people can take their phone to pastoral support, a health professional, and/or a trusted adult/professional listed on the display poster at your venue/organisation to seek support without having to speak.  Your team/trusted adult can then take the necessary action to support that young person using the card as a starting point for any conversation.

The young person does not need to complete the entire form, only the questions they feel are relevant to their situation.

Once the form has been seen by a professional, the information can be noted, and the young person can delete the form from their phone thus maintaining confidentiality.

Apply for posters

On applying for posters, you will receive an email that will give you access to a video and PowerPoint presentation. You can use the PowerPoint presentation as a talking point, assembly, and/or group session to introduce the reporting card and let young people know where to find the posters, the physical cards, and who to share them with.

You will also receive a link to downloadable posters suitable for environments with no phone access. These posters do not include the QR code and instead, a space to complete where to collect the paper report cards and who to take them to. These are available in both a colour format and easy print.

You can also request the resources in a format suitable for embedding on an intranet.

Reporting Card FAQ

When can I start displaying the posters?

Posters are available from Lancashire Mind and you can display them as soon as you have completed the relevant details of who to share the card with within your organisation. Please ensure that the named person/people have the appropriate experience and/or training to support the young person and you have a safeguarding policy in place for your organisation/venue.

How can we promote that we are displaying the Lancashire Mind posters so that young people will understand how to access them to get support?

On applying for posters, you will receive an email that will give you access to a video and PowerPoint presentation. You can utilise the video on social media and Lancashire Mind can support you in social media promotion. You might also choose to use the PowerPoint presentation as a talking point, assembly, and/or group session to introduce the reporting card and let young people know where to find the posters, the physical cards and who to share them with.

Where is the best place to display the posters?

Children and young people have told us that the place they are most likely to download the card is somewhere private, including changing rooms and toilet cubicles as they would not want to be seen downloading it.

Do I need to do anything with the posters before displaying them?

Please add the names of any designated members of staff in the appropriate boxes so that the young person knows whom to take the card to. Also, add where young people can collect printed versions of the card at your venue/organisation.

What if a young person can't download the card or doesn't have a phone?

They will need a pdf reader app on their phone to access the card, most new phones have this but if they are unable to download a pdf reader please provide them with a paper copy of the card. Details of this are listed on the download page.

You will also receive a link to downloadable posters suitable for environments with no phone access. These posters do not include the QR code and instead, a space to complete where to collect the paper report cards and who to take them to. These are available in both a colour format and easy print.

For young people who do not have a phone or device, they can utilise the printed versions of the card which you can print out yourself. You can purchase a display stand, to promote the cards with the relevant branding which aligns with the posters so that young people will easily identify where the cards are being stored and take a card discreetly

Where do I get the printed versions of the card?

When ordering the card you will receive an email with a link to a printable version of the card to promote accessibility. You can then return to this page and print as many cards as you require to promote the sustainability of the offer.

Where do I get the stand to display the printed versions of the card?

On applying for the posters you have the option to purchase a display stand for £5, this price is inclusive of postage and the stand will be sent out to you with the posters.

Where is the best place to display the stands and printed versions of the card?

These are best displayed in reception areas and waiting rooms of pastoral support or in more discreet areas such as changing rooms or wash rooms.

Where can we upskill our staff to talk about self harm and ensure we have the right approach in place to deal with these conversations?

Lancashire Mind is able to offer a range of training opportunities to suit all budgets and requirements to upskill staff about self-harm conversations, identifying self-harm behaviour, and supporting young people.