Self-harm and moral codes in emergency departments in England

This article uses a theory of 'moral codes' to analyse the treatment of non-fatal self-harm in emergency departments in the NHS in England. It argues that self-harm has historically been the object of various moral classifications ranging from criminality, to immorality, to mental illness. In the contemporary situation, these classifications are highlighted in two areas of health and social policy: first, in terms of the implementation of the National Institute of Health and Care Excellence's clinical guideline on self-harm; second, in terms of the application of Section 136 of the 1983 Mental Health Act to individuals who self-harm or who are at risk of self-harm and are brought to emergency departments by the police. The main influences upon the theoretical framework employed are Durkheim, Parsons, especially his concept of the sick role, and Alexander.