Self harm

Question 1

What is the definition of self harm?

Answer 1

Intentional act of self-poisoning or injury – expression of emotional distress

Question 2

How common is self harm?

Answer 2

Lifetime prevalence of 5-6% in the UK

Question 3

What are the pathology of self harm?

Answer 3

• Includes physical injury, poisoning, misusing substances, anorexia, bulimia, excessively exercising

Question 4

What are the risk factors/aetiology of self harm?

Answer 4

• Stressful/emotional situations
• Social problems e.g. bullying, difficult relationships, arranged marriage
• Trauma e.g. abuse, miscarriage
• Psychological e.g. hallucinations/delusions to harm themselves, disassociating, personality disorder

Question 5

What are the signs/symptoms of self harm?

Answer 5

• Behaviour e.g. self-cutting intended to cause harm
• Ingesting a substance in excess
• Ingesting recreational/illicit drugs
• Ingesting a non-ingestible substance/object
• Done in private/hidden
• Unexplained cuts/burns
• Keeping themselves covered at all times, inc. in hot weather
• Depression signs/symptoms
• Anxiety
• Self-loathing/expressing wishes to punish themselves
• Becoming withdrawn
• Suicidal thoughts
• Changes in eating habits/weight loss or gain
• Low self-esteem

Question 6

What investigations are carried out for those who self harm?

Answer 6

• Risk assessment

* Full mental health/social needs assessment

Question 7

What are the pharmacological treatments for self harm?

Answer 7

• Activated charcoal – given as early as possible, preferably within 1 hour of ingestion
• Antidepressants – be cautious

Question 8

What are the non pharmacological treatments for self harm?

Answer 8

• Refer to A&E
• Psychological intervention
• CBT
• Support organisations