Deliberate self-harm

Deliberate self-harm is one of the most common reasons for emergency medical admission but remains a difficult and frustrating problem to manage, particularly in the longer term. Internationally the prevention of suicide has become a priority on the health agenda and measures aimed at the reduction of deliberate self-harm are considered central to that. There is a considerable body of epidemiological work highlighting changing trends in the at-risk population, yet so far this has been of limited value in developing effective management strategies. Psychological interventions developed in secondary care have shown some benefit but there is a need for such interventions to be evaluated in large populations, and given the prominent role of primary care in the aftercare of patients who deliberately self-harm this may be the most appropriate setting in which to determine their effectiveness.