Self-cutting and harm reduction: Evidence trumps values but both point forward

Geoffrey L. Dickens*, Leah Hosie

*Corresponding author for this work

Research output: Contribution to journalEditorialpeer-review

4 Citations (Scopus)


Self‐harm is common on mental health wards, an unsurprising fact given that the patient group comprises some of the most unwell people from the local community. One systematic review of 25 studies (Swannell, Martin, Page, Hasking, & St John, 2014) suggested a pooled prevalence for self‐harm by inpatient mental health service users of 17.4% (range 0.7%–68.8%) including up to 21% specifically by self‐cutting. It has long been recognized that custodial, coercive approaches to inpatient self‐harm management are problematic, invalidate the individual's distress and disrespect their agency and autonomy. Over the years, the issue of harm‐reduction approaches to self‐harm has been periodically raised, most commonly as discussions of ethical and legal obligations and boundaries (Sullivan, 2017). While periodic re‐examination of the fundamental principles underlying different courses of nursing management is meritorious, it is only by the generation or acquisition of new data that we can truly move the debate forward. Put bluntly, while values are important, new evidence can create the conditions for change.
Original languageEnglish
Pages (from-to)529-530
Number of pages2
JournalJournal of Psychiatric and Mental Health Nursing
Issue number9-10
Early online date2 Dec 2018
Publication statusPublished - 21 Dec 2018
Externally publishedYes


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