Suicide Ideation / self-harm
Suicide and self-harm is a silent crisis that cuts across age and gender, and it is important to address it promptly.
In 3 years, from 2019 to 2021, adolescent suicide rates in Singapore nearly doubled from 5.31 per 100,000 to 9.14. Suicide is the leading cause of death for men below the age of 50.
What Is Suicide Ideation And Self-Harm?
Suicide ideation refers to thoughts about ending one’s life. These thoughts can range from fleeting feelings to detailed plans. Most suicidal thoughts do not progress to a suicide attempt.
Self-harm is when someone intentionally hurts themselves, usually as a way to cope with overwhelming emotions, stress, or numbness. It is not always connected to suicidal ideation, but it can still be dangerous and distressing.
Types Of Self-Harming Behaviours
There are many forms of self-harming behaviours, some being more common than others. All types come with significant risk.
Some of the common self-harming behaviours are:
- Cutting – with the help of sharp objects, to break or injure the skin
- Burning – with hot items like cigarettes, matches or sharp objects that have been heated, or with chemicals
- Hitting – this can include punching a wall, or banging your head against a wall, causing impact injuries
- Scratching or rubbing – resulting in skin damage
Causes And Risk Factors
Suicide ideation and self-harm are ways often used to cope with deeper emotional pain, stemming from a mix of social, psychological and personal factors.
Some common causes include, but are not limited to:
1. Mental Health Conditions
- This can include PTSD, depression, anxiety, and Borderline Personality Disorder (BPD), which can make it difficult to manage emotions.
2. Trauma or Abuse
- Any form of abuse can leave a lasting psychological impact.
3. Low Self-Esteem or Persistent Negative Self-Image
- This can fuel self-critical thoughts.
4. Family Conflict or Instability
- This includes neglect or lack of emotional support at home.
Often, these factors overlap, and the reasons behind suicide ideation and self-harm are deeply personal.
When To Seek Help?
If you have suicidal thoughts or think about engaging in self-harm, you must seek help immediately.
If you are in immediate danger or putting others in danger, please contact your local emergency line (995 in Singapore).
Some symptoms and warning signs include:
- Sudden mood changes or agitation
- Unexplained injuries (cuts, bruises, burns)
- Wearing long sleeves even in hot weather
- Keeping sharp objects or tools hidden
- Feeling hopeless or like a burden
- Guilt, shame, or worthlessness
- Isolation or withdrawal from friends, family, and previously enjoyed activities
- Has a specific plan for suicide or self-harm
- Has access to means of self-harm (weapons, medications, etc.)
- Gives away possessions or says goodbye in unusual ways
- Engages in increasingly risky or self-destructive behaviours
Seek professional support immediately when experiencing:
- Persistent thoughts of death or suicide, even without a plan
- Inability to cope with daily activities or responsibilities
- Significant changes in sleep, appetite, or energy levels
- Substance abuse as a way to cope with emotional pain
- Previous suicide attempts or family history of suicide
- Self-harm behaviours, regardless of perceived severity
Addressing Suicide Ideation/ Self-Harm And Crisis Support
It is important to know that help is available and recovery is possible. Some common treatments include:
Medication: antidepressants, mood stabilisers (prescribed)
It is important to know that medications can significantly reduce the frequency and intensity of symptoms, making it easier for individuals to function in their daily lives, but is not a cure. They are most effective when monitored by the prescribing clinician, as dosages may need adjusting, and side effects should be monitored.
Safety plans: made alongside your clinician
Creating a safety plan with a mental health professional can include:
- Identifying personal warning signs and triggers
- Listing coping strategies that have worked in the past
- Contact information for supportive friends, family, and professionals
- Steps to take during a crisis, including removing access to means of self-harm
- Reasons for living and personal motivations for recovery
Support groups
These are gatherings (online or in-person) of individuals who share experiences with mental health issues. They are often peer-led or led by a professional. Support groups offer a sense of community and belonging, reducing feelings of isolation; however, they may not be ideal for everyone.
If you are in crisis or need urgent help in Singapore, contact:
- Samaritans of Singapore (SOS) – 24/7 support: 1767
- Institute of Mental Health (IMH) Helpline: 6389 2000
- Emergency (Life-threatening situations): Call 995 or go to the nearest A&E
How Can Us Help You?
Experienced Therapists
Our processes and quality assurance is led by Dr.Emma Waddington, a UK-trained senior clinician psychologist and Founder of Us Therapy, with over 20+ years of experience in helping individuals in Singapore.
Holistic & Personalised Approach
Our clinicians draw from various therapeutic models to create a holistic approach. At Us, we have seen hundreds of clients and we recognise that each individual is unique. Our approach is tailored to you but always includes customised treatment plans and integrative techniques.
Thorough Assessment
At Us, we pride ourselves on our comprehensive assessment processes. We will undergo a thorough assessment process with you in your first sessions before we come up with a plan for your therapy.
Therapy Approaches
Cognitive Behavioural Therapy (CBT)
CBT helps to identify and challenge negative thought patterns that contribute to suicide ideation and self-harm. It focuses on developing healthy coping strategies to enhance emotional regulation and modify negative self-beliefs.
Dialectical Behavioural Therapy (DBT)
DBT was originally developed for those with chronic suicidal thoughts and self-harming behaviours (especially those with borderline personality disorder). It combines CBT techniques with mindfulness.
Trauma Therapy
Often, self-harm and suicide ideation stem from past trauma. Trauma-focused therapies like EMDR or Trauma-Focused CBT aim to address and process these memories
Psychodynamic Therapy
It explores unconscious thoughts, relational patterns and early life experiences that can contribute to self-destructive behaviours. By increasing insight, clients can develop a more compassionate self-view.
What To Expect
Initial Consultation – A Space to Be Heard
The first session is all about getting to know you. It is a conversation—one where you can share what is been on your mind, what has been feeling difficult, and what you would like support with. Your therapist will ask questions about your background, experiences, and goals, but there is no pressure to answer any questions—just a safe space to begin.
Questionnaires & Onboarding Surveys – Understanding the Full Picture
To help tailor therapy to your needs, you may be asked to fill out some brief questionnaires before or after your first session. These can give insight into things like mood, stress levels, relationship patterns, or coping strategies. They are not tests—just tools to help your therapist understand how best to support you.
Individual Therapy Sessions – Your Journey at Your Own Pace
Each session is a step forward in your journey. Therapy is not just about talking—it is about discovering new ways to navigate life’s challenges, make sense of emotions, and feel like you are getting the most out of your life. Depending on your needs, sessions may focus on:
- Exploring patterns of thought and behavior
- Understanding past experiences and their impact on the present
- Developing practical coping tools
- Strengthening emotional resilience
Feedback Sessions – Reflecting and Adjusting
After the first few sessions (or after assessments), a feedback session provides space to reflect on how therapy is going. This is a chance to talk about what has been helpful, what you would like more of, and how therapy can continue to best serve you.
Intervention – The Heart of Therapy
Intervention is where meaningful change happens. Every therapy journey is unique, and the approach will be shaped around what works best for you. Some common approaches include:
🌱 Cognitive Behavioral Therapy (CBT) – Helping to identify and shift unhelpful thought patterns, reduce anxiety, and develop healthier ways to cope and new patterns of behaviour.
🧠 Schema Therapy – Deep, transformational work to uncover long-standing patterns that might be keeping you stuck, often rooted in early life experiences.
💙 Acceptance and Commitment Therapy (ACT) – Learning to handle difficult emotions with self-compassion and move towards what truly matters in life.
🌊 Eye Movement Desensitization and Reprocessing (EMDR) – A powerful approach for healing trauma and distressing memories, helping the brain reprocess them in a way that feels less overwhelming.
🧘 Mindfulness-Based Approaches – Building self-awareness, grounding techniques, and ways to manage stress and emotions with greater ease.
Fees
Individual Counselling Rates
Clinician type
Fees and Duration
Clinic Founder
$310
Principal Psychologist
$290
Senior Clinical Psychologist
$262
Educational Psychologist
$262
Clinical Psychologist
$236
Counsellor
$170
Expressive Arts Therapist
$170
Associate Psychologist
$130
Phone calls / Emails
Clinicians rate pro-rata (10 Mins)
FAQs About Suicide Ideation/ Self-Harm
Should I see a psychiatrist for self-harm?
You can see a psychiatrist or a psychologist if you or your loved one is self-harming or at risk. Psychologists cannot prescribe you medication; they can provide therapy and counselling. Oftentimes, clients see a psychologist or therapist weekly/ biweekly, and a psychiatrist if they require any medication.
How do I get out of self-destruct mode?
Identify your triggers and replace any harmful patterns with healthier activities, like journaling or going on a walk. Therapy can be beneficial in helping you build emotional regulation skills and in creating a safety plan, which is very important for those who self-harm or have suicidal ideation.
What can a GP do about self-harm?
GPs can refer you to psychologists and psychiatrists for your next steps, whether that be for therapy, diagnostics, medication and more.
What are good ways to distract yourself?
- Hobbies like art and sports
- Spending time with loved ones
- Joining clubs
- Journalling