Commonly, self injury is dialogue with yourself, an expression of inexpressible emotion, or an absence of self-value. Self harm is a private activity. It's not about its effect on others. Self-harmers are usually hysterical women under thirty who grow out of it. Traditionally this has been the asusmption.
Recent research shows the difference in rate of self injury in men and women is less marked.
How severe staff think the wound is won't tell them how bad the person feels. If you won't see the psychiatrist, you can't want to get better. Psychiatry has had little or no success in helping individuals who self injure. Neither drug nor behavioural treatments can address the issue of self worth. Either they enjoy pain or they can't feel it.