ABSTRACT
Different forms of deliberate self-harm have been present throughout history and across all cultures, dictated by religion, society or fashion, including such diverse practices as self-flagellation, foot-binding and body piercing (Johnstone, 1995). Self-harm also occurs in the context of almost any psychiatric or brain disorder, for example in psychosis, severe depression, dementia and severe learning disability. The present chapter will not consider the needs of these cases. Instead we will focus on the majority of cases presenting to psychiatric services or to Accident and Emergency Departments, who do not suffer from severe mental illness or mental impairment. In these cases self-injurious behaviour often is an expression of psychological distress at a time of life-crisis in vulnerable individuals.
