Discuss the management of persons involved in deliberate self harm.

People who engage in self-harm deliberately hurt their bodies. The term 'self-harm' refers to a range of behaviours, not a mental disorder or illness. The most common methods of self-harm among young people are cutting and deliberately overdosing on medication. Other methods include burning the body, pinching or scratching oneself, hitting or banging body parts, hanging, and interfering with wound healing.

In many cases self-harm is not intended to be fatal, but should still be taken seriously. While it might seem counter-intuitive, in many cases, people use self-harm as a coping mechanism to continue to live rather than end their life (3). For many young people, the function of self-harm is a way to alleviate intense emotional pain or distress, or overwhelming negative feelings, thoughts, or memories. Other reasons include self-punishment, to end experiences of dissociation or numbness, or as a way to show others how bad they feel.

Many young people might try to hide their self-harming behaviour, and only approximately 50% of young people who engage in self-harm seek help. Often, this is through informal sources such as friends and family, rather than professionals.

While every person is different, there are some warning signs that someone might be self-harming. Aside from obvious signs such as exposed cuts or an overdose requiring intervention, some less obvious signs could include (5):

Psychological signs:

• Dramatic changes in mood
• Changes in sleeping and eating patterns
• Losing interest and pleasure in activities that were once enjoyed
• Social withdrawal - decreased participation and poor communication with friends and family
• Hiding or washing their own clothes separately
• Avoiding situations where their arms or legs are exposed (eg, swimming)
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