Something I was helping with recently is a scheme for people who have self harming tendancies to take up sports where there is a risk of injury. I was teaching a group of teenagers who have all tried suicide before to snowboard, and they were having a good time doing it.
A lot of shrinks say that snowboarders are glorified self harmers putting our lives at risk for fun, and we may well be, but we gain injuries as a side effect of the sport. Not deliberate.
It may be worth a shot if the normal doctor advice / plans / whatever don't work, to try snowboarding or dirt biking or whatever, something extreme, and if you stack it, you've got the harm there, but it isn't a deliberate concious action.
It's just an alternative idea to the regular old routine for getting past self harming, and it's a lot more fun than meetings and shrink visits.