Scientist Says Allow Some Mental Health Patients to Self Harm

A scientist say mental health units should consider providing sterile cutting equipment to patients who self-harm rather than forcibly stopping them. It is argued that confronting them can be more damaging in the long run.

Patrick Sullivan, a mental health care researcher, is recommending that doctors allow some of their patients to continue to self harm and provide them with safety information, sterile equipment and therapy to understand their actions and help them develop alternative coping strategies.

He argues that confronting them could prove more damaging in the long run.

Prevention vs. Understanding?

In the Journal of Medical Ethics, Sullivan wrote: “The first problem with a preventative strategy is that it can exacerbate rather than contain the problem.”

Sullivan argues that enforcing interventions on patients who self-harm “are likely to produce a confrontational rather than therapeutic environment that increases levels of distress and reduces the chance of a positive outcome in the longer term.”

“Many individuals who self-injure have a history of abuse or trauma and preventative measures may increase their feelings of powerlessness and in extreme cases result in additional trauma and therapeutic alienation,” he wrote.

“This increases the risk that individuals will self-injure covertly, in more dangerous ways, or attempt suicide.” Sullivan acknowledged that preventing self-harm was appropriate in circumstances such as when the patient’s life was in danger, but that this should be considered as well.

Comments on Sullivan’s Proposal

Some mental health experts have shown concern about the ethical, legal and practical implications of Sullivan’s suggestion.

Doctors Hanna Pickard and Steve Pearce said self-harm could reinforce feelings of low self-esteem. They also argued that it could sometimes be “contagious” among patients.

Dr Pickard, a researcher at the University of Birmingham, and Dr Pearce, of Oxford Health NHS Foundation Trust, also argued that it could be very distressing on staff should self-harming patients end up in serious injury or death.