Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-22T08:25:32.212Z Has data issue: false hasContentIssue false

17 - Self-harm

Published online by Cambridge University Press:  02 January 2018

Sophie Roberts
Affiliation:
BMedSc, MBBS, MRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
Phil Lucas
Affiliation:
Consultant Child and Adolescent Psychiatrist
Barry Wright
Affiliation:
Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
Greg Richardson
Affiliation:
MBChB, DCH, DPM, FRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
Get access

Summary

‘It isn't as if there was anything wonderful about my little corner. Of course for people who like cold, wet, ugly bits it is something rather special, but otherwise it's just a corner.’

A. A. Milne, The House at Pooh Corner

Introduction

Suicide has long been recognised as a societal phenomenon as well as an individual one (Durkheim, 1970) and national strategies have been developed to address this (Department of Health, 2002).

Approximately 7–14% of adolescents harm themselves at some point; 20% will think seriously about it (Madge et al,2008; O'Connor et al2009), representing a considerable workload for CAMHS, both numerically and in terms of the risk posed and anxiety generated, and it is recognised that many such young people do not even reach the attention of health services (Hawton & Rodham, 2006). The most common forms of self-harm are cutting, scoring, scratching, overdosing and less commonly burning or punching. Most young people describe that they self-harm to forget about stress, relieve anxiety and, less commonly, to kill themselves (Young et al, 2007).

Most are not suffering from mental illness, although it is the responsibility of CAMHS to assess and treat these young people, as well as the anxiety engendered in others. Around 0.5–1% of young people who present following an episode of self-harm complete suicide, and 40% of those who survive a first attempt will repeat it; CAMHS should aim to reduce these figures.

Such young people may be referred to a CAMHS at a number of points in the cycle of self-harm (Box 17.1). Clinical and epidemiological information is readily available to inform practice in the management of self-harm (Rutter, 1990; Kerfoot et al,1996; Meltzer et al,2001; Wood et al,2001; Gould et al,2003; Fox & Hawton, 2004).

Providing a service

The assessment of the young person who has primarily self-harmed should be regarded as part of the everyday work of CAMHS. A speedy response can help alleviate anxieties. Competence, calmness and clarity of thinking is more important than the professional background of the assessor.

Type
Chapter
Information
Child and Adolescent Mental Health Services
An Operational Handbook
, pp. 162 - 168
Publisher: Royal College of Psychiatrists
Print publication year: 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Self-harm
    • By Sophie Roberts, BMedSc, MBBS, MRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust, Phil Lucas, Consultant Child and Adolescent Psychiatrist, Barry Wright, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust, Greg Richardson, MBChB, DCH, DPM, FRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
  • Edited by Greg Richardson, Ian Partridge, Jonathan Barrett
  • Book: Child and Adolescent Mental Health Services
  • Online publication: 02 January 2018
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Self-harm
    • By Sophie Roberts, BMedSc, MBBS, MRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust, Phil Lucas, Consultant Child and Adolescent Psychiatrist, Barry Wright, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust, Greg Richardson, MBChB, DCH, DPM, FRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
  • Edited by Greg Richardson, Ian Partridge, Jonathan Barrett
  • Book: Child and Adolescent Mental Health Services
  • Online publication: 02 January 2018
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Self-harm
    • By Sophie Roberts, BMedSc, MBBS, MRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust, Phil Lucas, Consultant Child and Adolescent Psychiatrist, Barry Wright, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust, Greg Richardson, MBChB, DCH, DPM, FRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
  • Edited by Greg Richardson, Ian Partridge, Jonathan Barrett
  • Book: Child and Adolescent Mental Health Services
  • Online publication: 02 January 2018
Available formats
×