Nearly one in four people would not feel comfortable talking to their GP about self-harm, according to a new report.
Samaritans Scotland found 24% of respondents to a survey would find this difficult.
Almost nine in 10 adults (89%) told the charity they believe self-harm is a serious issue in Scotland and would like more to be done to improve it.
But in the report, Hidden Too Long: Uncovering Self-Harm in Scotland, Samaritans Scotland found two in five adults (40%) would not know how to support someone close to them if they were self-harming.
The survey of more than 1,000 adults also found nearly a third (31%) would not feel comfortable talking to their partner or close family about self-harm, while nearly two in five (39%) would not feel comfortable talking about it with friends.
Now, Samaritans Scotland is calling for a new national strategy to improve understanding of self-harm and strengthen support for those affected.
The charity’s executive director, Rachel Cackett, said: “Although self-harm remains a taboo subject for many, and is notably absent from key national strategies, we know it is an issue which affects many, many individuals, families and communities all over Scotland.
“Recent data shows that one in six young people aged 16-24 in Scotland have self-harmed at some point in their lives, while the proportion of adults who reported ever self-harming in Scotland rose from 3% in 2008-09 to 7% in 2018-19.
“It’s too early to know how the coronavirus pandemic and related restrictions will affect mental health in the long term but we are particularly concerned about the potential impact on already high-risk groups including young people, women, middle-age men, people with pre-existing mental health conditions and people experiencing deprivation.”
She added: “We want policymakers to consider how they can work with individuals, families, communities and services to tackle stigma, strengthen support and address the underlying causes of self-harm.
“And we want to know that if someone takes the brave step of asking for help with their self-harm, the understanding, care and support they need will be there.”
Steven Fegan, from Ayrshire, said he began self-harming during a difficult period his life.
After seeking support, he went on to become a Samaritans supporter and is now training to volunteer with the charity’s 24-hour helpline.
Mr Fegan said: “I know from my own experience how difficult it can be to ask for help when you’re struggling.
“The stigma around self-harm left me feeling ashamed and like I needed to hide what I was going through, even from the people closest to me.
“But when I eventually did reach out and ask for help, I was met by people who cared – they listened and supported me without judgment.
“And that was life-changing – even life-saving.”
He added: “I hope that by talking openly and honestly about self-harm we can improve understanding, encourage more people to ask for help and ensure that the right support is there when they do.”