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Lecture notes Acute Care (SHN2004)
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Managing Deliberate Self Harm
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SHN2004 – Managing Deliberate Self HarmManaging Deliberate Self Harm
Learning objectives
To understand what self harm is
To develop a greater understanding of the reasons why people self harm
To feel confident to help manage a person who self harms
To give you an opportunity to explore this subject
Self harm vs Suicide
Self harm is distinct from suicide and suicidal acts by means of intention
Suicide seeks to end all feelings
o Para-suicide where someone has attempted to commit suicide but it has not
been successful
Self harm is seeking to feel better by relieving those symptoms at that time
o This is where suicide has been attempted but without the intention to die
Self-harm and suicidal behaviours overlap but yet are distinct
A self injury may, for example, be a ‘failed’ suicide while a suicide may be an episode
of self-harm that ‘went wrong’
However, some people will say they harm themselves so that they don’t feel suicidal
More males commit suicide but more females harm themselves
Both types of behaviour increase the risk of subsequent related behaviour
What is Self Harm?
“Self poisoning or Self Injury, irrespective of the apparent purpose of the act. Self
harm is an expression of personal distress, not an illness and there are many and
varied reasons why a person may self harm” Nice guidelines 2004
What self harm means for some people:
o “When I self-harm it is me telling the outside world what I feel inside, which I
can’t express in words. Often it is an alternative to me attempting to kill
myself. All that I really want is someone to hug me and let me talk to them”
o Some people view this as attention seeking this is exactly what it is a cry
for help. A sign that something is wrong in the life of the person
o As a nurse take time to try and signpost individuals to services that can offer
them the help and support they need (rather than just patching them up in
A&E and sending them home)
How common is it?
The UK has one of the highest self-harm rates in Europe (1–3)
Self-harm is more common in veterans, young people, women, LGBT+, prisoners,
asylum seekers, and those who’ve been abused (4)
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, SHN2004 – Managing Deliberate Self Harm
Self-harming behaviours can begin at any age, but commonly start between ages 13
and 15 (5)
About 18% of students aged 12-17 report self-harming at some point in their life.
Self-harming is 2-3 times more common females (6)
25.7% of women and 9.7% of men aged 16-24 report having self-harmed at some
point in their life (7)
18,778 children and young people were admitted to hospital for self-harm in England
and Wales in 2015/16, a 14% rise from 2013/14 (8)
o CYP would be admitted into hospital from A&E if found to have self-harmed
o To a degree self-harm has replaced smoking as a form of rebellion amongst
teenagers it is something people can do privately and also to feel part of a
group
Influenced by social media and trends on platforms like Tik Tok
In 2018/19, ChildLine provided 13,406 counselling sessions about self-harm across
the UK (9)
People who self-harm are approximately 49 times more likely to die by suicide (10)
Information from MHFA England, 2020
Why do People Self Harm?
Have you ever drunk too much?
Do you eat the wrong things in the wrong amounts?
Self injury can be viewed as an extreme form of other dangerous activities that many
of us regularly indulge in.
o People can self-harm in ways other than physically taking a knife to their
wrists etc. Self harm can take many different forms
Word storm: types of self-harm that you have come across
Anything that can be done to excess as a means of making yourself feel better no
matter what the consequences
o E.g. spending when you don’t have the money; gambling; drinking to excess
regularly to feel better;
Cultural & social impact
Some self harm is socially sanctioned
o Rituals
o Community traditions
o Healing
o Group identification
and some is not
o Suicidal intent
o Self injury
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