Assessment and management of self harm
Students and junior doctors must be able to identify those at risk and provide management options
- By: Nicolas Suarez, Kate Saunders
Self harm is defined as “self poisoning or injury, irrespective of the apparent purpose of the act.”1 This definition includes poisoning, asphyxiation, cutting, burning, and other self inflicted injuries. Despite the high prevalence of self harm, there is no international agreement about its definition. Medical students and junior doctors working in psychiatry or accident and emergency departments must be able to assess and manage individuals who have self harmed, and know how to deal with and what to say to a person who has suicidal intent.
Some doctors and researchers draw a distinction between acts with clear suicidal intent and those with no such intent. This distinction has resulted in the proposed inclusion of non-suicidal self injury as a separate diagnostic category in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, the mental health disorder classification system currently being updated by the American Psychiatric Association. The