Deliberate Self-Harm

What is your best first action?

You sit with Philip and try to explain to him why you would like to examine his arm. He tells you to fuck off again, but also throws the cloth covering his arm at you. A clear view of his arm is reassuring he has three cuts on his forearm, each is superficial, clean, no longer bleeding. You note multiple scars on his forearm, but they all seem to have healed cleanly.

What is the next best step?

You tell Philip that the Liaison Team have said that they will be down to see him shortly, and that you probably won’t see him again this evening. Philip then tells you that he cut himself because he is exhausted from lack of sleep. The only thing that helps him is Temazepam.  As it’s Friday evening, he can’t get any from his GP. Can you give him some? He further tells you that his sleep is so bad that he needs at least 30mg to get any rest at all.

What is your next step in his management?