The problem of deliberate self-harm

This paper focuses on the management of deliberate self-harm. Guidelines on the management of deliberate self-harm have been available for the past 6 years, but they are not widely followed, with less than half of patients having a psychosocial assessment after an episode of deliberate self-harm. The availability of paracetamol has been restricted (blister packs and limited quantities), resulting in a reduction in the dosage levels of paracetamol ingested, but not in the numbers of patients that need to be referred to tertiary services for treatment of liver damage. An important medicolegal issue has been raised concerning patients who refuse treatment after a potentially life-threatening overdose. Approaches to dealing with this situation have attracted considerable attention during the past year. Two new brief and focused treatments for the management of deliberate self-harm have been reported (Manual Assisted Cognitive Therapy and Cognitive Analytic Therapy), but further research is required before they may be used in routine practice. Curr Opin Psychiatry 14:107-111. (C) 2001 Lippincott Williams & Wilkins.