chapter  5
Suicide and self-harm: clinical risk assessment and management using a structured professional judgement approach
Pages 27

Suicide and self-harm are the daily concerns of practitioners in mental health and correctional facilities all over the world (Hawton and van Heeringen, 2000). Wherever there exist people in distress – for example, as a result of mental health problems of a variety of different kinds, traumatic experiences, excessively demanding social circumstances, or chronic or serious physical illness – there is the potential for some to harm themselves as a way of responding to the distress that they feel. Some will seek an end to all that they know and will act with the explicit intention of terminating their lives by the act of suicide. In others, the purpose of self-harmful behaviour may be less clear and death or serious injury may result from acts that suggest an ambivalence about living or a reckless disregard for their own safety, and sometimes for the safety of others as well. And in others still, the intention may not be to die at all but instead to feel pain or to see blood or injury as a means of expressing emotions, releasing fears or internal distress, communicating, or controlling others or the situations that they are in.