I was straight on the phone for a referral when dd revealed that she was cutting herself. Long waiting lists, but when I spoke to the school counsellor, she went straight to the phone and got us a referral.
Can't help thinking you left something out of your list, though, HeyHo:
"If they have great coping mechanisms, great support, close healthy relationships, friends, interests, take regular exercise etc, it tends to be a specific thing or event that overwhelms them - an incident of severe bullying, assault, hidden eating disorder etc
If they have poor relationships, dispruted family attachments, inappropriate boundaries, too much frredom etc, it can be less of a distinct "thing" that makes them harm, it can be something seemingly trivial, a mood, a distraction."
Dd has good relationships, strong family attachments and, I think, appropriate boundaries, but a strong predisposition to anxiety which is a known factor in her particular genetic disorder.
Sometimes it will take the form of self harming (or suicide attempts), sometimes of vomiting, or hyperventilating, or severe back ache. It's not just one thing, or one event; it's about how her body handles stress and that was apparent when she was very small.
CAHMS have told her quite frankly that this predisposition is something she will have to factor in when she works on coping mechanisms, because like her physical disability that will probably always be part of her.