If you are in enough mental distress self harm starts looking like a real good idea as an excuse to not go to work. Of course it’s not logical or reasonable. It’s a reaction to stress. It’s an irrational intrusive thought.
If I hadn’t experienced something similar I would feel a little skeptical. :(
It’s hit or miss. Some employers check your references diligently and others don’t.
When I hired someone (creative field) we definitely checked their job title in conjunction with what their portfolio looked like, whether they passed a test and how well they interviewed.
Some had great references, but not those other things.
If you can’t do your job and don’t know basic things, I don’t care who you know. They would get further screened for educational and criminal background anyways.