The deliberate self‐harming behaviour of patients within a British special hospital

Abstract

Within more conventional discourse amongst health-care professionals, 'deliberate self-harm' is largely conceived in pejorative terms. Unlike other so-called 'pathological' behaviour for which the 'sick' are not held wholly responsible, this particular behavioural mosaic carries within its very conception quite different connotations of 'intentionality'. This project constituted a retrospective survey of the phenomenon amongst patients resident within a British special hospital, over a 6-month period, in 1987, prior to the establishment of a unit for disturbed females in November of that same year. It illustrated that the scale, and nature, of the problem was comparable to any of the other much-publicized accounts that have emerged from other custodial establishments. It is the contention, here, that patient characteristics alone are an insufficient explanation for the level of self-harm that prevails and that significant, alternative considerations are available. It is intended that this paper should contribute to the evaluation of the clients' predicament, and the institutional management of their self-harm, within an environment such as a special hospital in the hope that a clearer understanding, and strategy, may be elaborated.

The prevalence and frequency of deliberate self‐harm among male patients in a maximum secure hospital

“…First, there is the issue of whether or not self-harming behaviours that are motivated by suicidal intent should be classified as incidents of DSH (Walsh and Rosen, 1988;Allen, 1995;Herpertz, 1995). Some studies have considered DSH to consist of certain behaviours regardless of whether or not they were accompanied by suicidal intent (Whitehead et al, 1973;Burrow, 1992;Low et al, 1997). Other authors have explicitly stated that behaviours that are motivated by a desire to commit suicide should not be considered as incidents of DSH (Favazza, 1989;Favazza and Conterio, 1989;Winchel and Stanley, 1991;Favazza and Rosenthal, 1993;Herpertz, 1995;Swinton et al, 1998).…”

“…Third, Walsh and Rosen (1988) discussed the issue of whether or not sociocultural norms should be considered when determining whether a behaviour is to be classified as an act of DSH. The various ways in which DSH has been conceptualized and the variety of terms that have been used to label these concepts have been described as constituting a 'semantic paella' (Burrow, 1992). Certainly, if definitions of it incorporate considerations of underlying intent and social acceptability, then a degree of subjectivity enters into the decision-making process as to whether or not any particular behaviour is to be classified as DSH.…”

Women who use secure services: applying the literature to women with learning disabilities

“…'In order to facilitate and maintain a secure base for patients, staff also require a secure base. Time for reflection and formal emotional support, should be an essential daily aspect of the role of clinical staff, rather than in times of crisis' (Wilkins and Warner, 2003:36) Self-injury Self injury in secure units has been found to be prevalent for both men and women (Burrow, 1992) and individuals who repeatedly self injure have been described as one of the most challenging groups of patients (Huband and Tantam, 2000). Self injury in the non learning disabled population is primarily defined as intentional harm to one's own body without conscious suicidal intent and may involve cutting, self poisoning, ingesting objects, self neglect, burning, breaking bones amongst many others.…”

Self-Embedding Behavior: A New Primary Care Challenge

“…[6][7][8] Common sites of selfinjury include the arms, wrists, ankles, and lower legs. [2][3][4] Often misdiagnosed, ignored, or underreported, self-embedding behavior (SEB) is a form of self-injurious behavior involving the insertion of inanimate objects into the soft tissues, either under the skin or into muscle. Originally described in their book Anomalies and Curiosities of Medicine, Gould and Pyle 9 compiled reports on adult European females with hysteria who demonstrated SEB ("needle-girls").…”

“…[1][2][3][4] Selfinjury refers to a broad class of experiences (suicidal and nonsuicidal) in which people engage in behavior that directly and deliberately destroys one's own body tissue. 5 This trend is not new or a phenomenon in adolescents; acts include cutting, burning, carving, hair pulling, inserting objects in body orifices, skin picking, and scratching.…”