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Harm Minimisation and self injury in the age of risk

Patrick Joseph Sullivan


Self-injury is a complex and challenging behavior commonly encountered by healthcare professionals working in the area of in-patient mental healthcare. In recent years there has been some support for the adoption of harm minimisation approaches in supporting people who self-injure. Harm minimisation approaches accept that self-injury sometimes functions as a way of helping people deal with distress. In accepting this perspective the patient is allowed to continue to self-injure safely, while undergoing therapy to develop different coping strategies. It is argued that for some people harm minimisation techniques are appropriate. However, the literature describes only limited examples in clinical practice. This paper will consider a specific problem associated with implementing harm minimisation approaches within an in-patient setting. It is argued that there are significant barriers to undertaking a programme of care that involves a significant element of risk taking, albeit that these theses risks are designed to have positive benefits for the patient in the longer term. This is due to a policy and legal framework focused on risk reduction. The adoption of harm minimisation approaches in this area of clinical practice would require significant changes in perspective in order for such practices to be adopted more widely.


Harm minimisation, implementation gap, person-centered healthcare, positive risk taking, self-injury

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