At what point is a counselor required to involuntarily commit someone to a hospital for self-harm? For example, can you tell them that you have self-harmed or that you have urges to self-harm, without the risk of being committed?

Most therapists will not commit you for self harming unless you are at risk of killing yourself by means of what you are doing. You can absolutely tell them about your urges and actions and I think that will be very beneficial to you. You can also directly ask the question to your therapist and they will answer you without risk of committing you.

Yes, you can let them know that you have self harmed without being committed. The only reason they would do this is if it seriously harmed your health (e.g. lost a lot of blood or starvation). From previous experience they have said it has to be serious to have someone committed to hospital. They will try to support you and will only feel the need to do this if they feel it could be life threatening. They will however inform you usually before they contact the hospital or other members of the mental health community.

Yes, you can. If you come to them bleeding severely, then they may have to take you. Otherwise, they bandage you up, and you are fine.

I believe so. There may be different rules in different countries, but to my knowledge, a therapist is only required to intervene if you are actively suicidal or homicidal (or actively want to harm someone else).

I would hope that any professional who has a good understanding of what purpose self harm serves would not even consider admitting someone involuntarily to a hospital because of a clients self harm. That being said, if it is believes that alongside self harm someone is seriously suicidal, then action may be taken to keep that person safe, which could involve involuntarily admitting someone to hospital if the person was not willing to accept treatment within a hospital environment. The only other time it could be considered is if a person self harms in public...but overall self harm is such a private act for many people who self-harm that they wouldnt choose to do this in a public place. Years ago doctors and other professionals found it difficult to differentiate between self harm and suicide and a question often asked to a self harmer who may have taken themselves to A&E for treatment for their injuries (if stitches were required etc) was "why were you trying to kill yourself?". The fact is without self harm, some people may have resorted to attempts on their life if they were unable to find any other alternate method of coping with their feelings etc. The goal of self harm is very rarely connected to suicide and therefore it would be unlikely that someone would be hospitalised for their self harm alone. Someone who self harms may have other mental health problems would could cause a team to consider hospitalising someone however.

This is very much up to the counselor. The key is to repeat that you are not suicidal and that the wounds don't require medical care. I've never had one even threaten to commit me and I've always done that.

Talking about self-harm to your counsellor is very important. A counsellor should only ever take someone to hospital if they feel there is serious and/or immediate danger to their health. Trust in your therapist and give them the chance to help you work through things.

Yes you can tell them without risk being sectioned. I am giving this information based on UK law and legislation. In the UK, you can only be detained under the Mental Health Act if professionals are concerned that you are an imminent danger to yourself or others and are too unwell to make decisions or understand that you need help. Even then, the counsellor would have to refer it and it will have to have two doctors who have seen you and an Approved Mental Health Professional (AMHP) all agree that sectioning you would be in your best interest. Normally they would also seek a voluntary section which is more flexible as you agree to it and only if refused (and you are assessed as being a serious and imminent danger to yourself or others,) then the decision may be made to make an involuntary section. So considering all of this, talking to your counsellor about self-harm is a very positive route to go down as they can help you overcome it, it shows that you are seeking help and want to get better, and unless you express that you are in immediate danger (this normally means immediate danger of committing suicide or hurting someone else) then sectioning won't be on the cards at all.

Yes. If you have self harmed before or are still strugglinf, in most cases a counselor will not admit you to a hospital. The only time when a professional is REQUIRED to call 911 or have you taken to a hospital is if you are suicidal or homicidal at the present moment.

Only when you're at a great risk of harming yourself badly. You should feel comfortable otherwise