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Psychological Medicine
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Harrison Howarth, Jim Bolton, Gary Bell
Self-harm is most commonly by self-poisoning or self-cutting. People who self-poison are more likely to seek medical attention; 80% of cases presenting to an emergency department are as a result of overdose with prescription or over-the-counter medication.
Children's mental health and wellbeing
Published in Jackie Musgrave, Health and Wellbeing for Babies and Children, 2022
Self harm is a term that covers a range of different acts that people do to deliberately cause pain or damage. The feeling that is experienced by people who self harm is sometimes described as a relief for overwhelming emotions. Please see guidance in the other resources section at the end of this chapter about how to approach a child who is self-harming.
Suicide and mental health
Published in Lorraine Bell, Helping People Overcome Suicidal Thoughts, Urges and Behaviour, 2021
To conclude, self-harm (which includes intentional self-poisoning or self-injury) is common, often repeated and associated with suicide. This highlights the importance of early intervention after an episode of self-harm in suicide prevention. Cooper et al (2005) suggest treatment should include attention to physical illness, alcohol problems and living circumstances. In 2010, the Royal College of Psychiatry report on Self-harm, Suicide and Risk recommended the provision of evidence-based psychological therapies for people who self-harm, which sadly, ten years later, many services still lack. In a Cochrane review of treatment for self-harm, Hawton et al (2016) conclude that Cognitive Behaviour Therapy (CBT)-based psychological therapy can result in fewer individuals repeating self-harm. In a study by Birkbak et al (2016), psychosocial therapy after deliberate self-harm led to reduced deaths, including deaths by suicide.
Correlates of self-harm in university students: A cross-sectional study
Published in Journal of American College Health, 2023
Kylie Griffin, Jasna Twynstra, Jason A. Gilliland, Jamie A. Seabrook
Self-harm is defined by the Canadian Mental Health Association1 as inflicting harm on one’s self without the intent to end life. Self-injurers make up about 1% of the Canadian population, with the majority being female.1 Although anyone may engage in self-harm, those who are experiencing a mental health disorder, particularly depression, are at greatest risk for self-harm.2 Additionally, a systematic review of longitudinal studies of non-suicidal self-injury (NSSI) and deliberate self-harm found that the prevalence of NSSI was highest around the age of 16 years.3 While NSSI and suicidal behavior are separate entities, adolescents who engage in long-term repetitive NSSI have a much higher risk for suicide ideation3 and suicide attempts later in life4 than those who do not engage in self-harm or very limited NSSI. Poor mental health is a major public health concern in Canada, and research suggests that mood disorders are most prevalent among those of university age.5
Hospital staff at most psychiatric clinics in Stockholm experience that patients who self-harm have too long hospital stays, with ensuing detrimental effects
Published in Nordic Journal of Psychiatry, 2022
Antoinette Lundahl, Gert Helgesson, Niklas Juth
Some of these reasons can seem paradoxical, since hospital care for these patients has no proven effect against self-harm behaviour, which includes suicidality, and the hospital care itself can even increase such behaviour [15,17,22,23,28,29]. The reasons for these detrimental effects of inpatient care can be several. As mentioned previously, conflicts and contagion of self-harm behaviour at the wards could be partial explanations [20,21]. Another explanation could be that inpatient care works as an avoidant coping mechanism for the patient, by temporarily alleviating the patient’s inner pain by conferring the responsibility for problem-solving and emotional regulation to others [28]. However, avoidant coping mechanisms, which can consist of behaviours such as self-harm or seeking inpatient care to escape emotional distress, are very short-term solutions and risk increasing the inner pain in the long term through a rebound effect, risk increasing the use of the avoidant coping mechanisms over time through reinforcement, and withhold the patient from learning more constructive methods to handle distress and adversities on her own [28]. This can be compared to addiction, where the drug temporarily removes inner discomfort but increases anxiety over time and increases the need for higher doses of the drug to alleviate the discomfort [28]. Also, the self-harm behaviour can become directly positively reinforced by inpatient care, by giving the patient extra care and affirmation as a response to her suicidality [28].
Brief Admission for Patients with Self-Harm from the Perspective of Outpatient Healthcare Professionals
Published in Issues in Mental Health Nursing, 2022
Amanda Arnold MSc, Rikard Wärdig PhD, Sally Hultsjö PhD
A key component and first line treatment in outpatient settings for patients with BPD includes some form of psychological intervention, often dialectical behavior therapy (DBT) (Linehan, 2015; Miller et al., 2006). Alongside individual psychotherapy, a skills training group is provided where the patients learn a variety of skills, including core mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance (May et al., 2016). DBT is the only empirically supported treatment for BPD and compared to other forms of treatment it has been more effective in reducing parasuicidal behaviors and reducing the number of inpatient hospitalizations (May et al., 2016; Paris, 2010). Patients who self-harm can also be provided with other types of social and emotional support, for example suicide prevention programs, where weekly medicine distribution and outpatient appointments are also available. However, creating a treatment plan is not always simple, and the lack of treatment specificity is the rule rather than the exception (Skodol et al., 2010).