Working with patients who deliberately self-harm

Deliberate self-harm can include a wide range of behaviours such as cutting, biting, picking, burning, insertion or ingestion of objects. It is common to a range of mental-health problems and its prevalence rate is estimated at between 2-6% of the population. Deliberate self-harm has the strongest correlation of all risk factors for suicide with up to 2% of people who self-harm dying within the following year, rising to 7% after nine years. A qualitative study involving eight community psychiatric nurses found that they struggled to conceptualize self-harm behaviour and found working with people who self-harm stressful, particularly in terms of managing the emotional impact upon themselves and the boundaries of their professional responsibilities in relation to managing risk. The therapeutic relationship was seen as crucial and a variety of coping methods to manage the impact of the work - which had largely developed through 'on-the-job' experience - were described in the study.

Thompson, Andrew R., Powis, Jane and Carradice, Angela - Community psychiatric nurses' experience of working with people who engage in deliberate self-harm International Journal of Mental Health Nursing June 2008, 17(3), 153-161