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 ha ving a psychosocial assessment after an episode of deliberate self-harm. Th e availability of paracetamol has been restricted (blister packs and limite d 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 t ertiary services for treatment of liver damage. An important medicolegal is sue has been raised concerning patients who refuse treatment after a potent ially life-threatening overdose. Approaches to dealing with this situation have attracted considerable attention during the past year. Two new brief a nd 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 pract ice. Curr Opin Psychiatry 14:107-111. (C) 2001 Lippincott Williams & Wilkin s.