What is self-harm?

While the term self-harm may at first seem self-explanatory, a universally accepted definition of this phenomenon is not easy to find. Professionals and organizations within which these disciplines work use a range of words to describe this behaviour. Various terminologies have frequently been used in the literature:

• Deliberate self-harm
  
• Self-injurious behaviour
  
• Repeated self-injury
  
• Self-wounding
  
• Para suicide
  
• Self-mutilation
  
• Self-wounding
  
• Episodic and repetitive self-injury
  
• Autodestructive behaviour.

Furthermore, definitions can vary from short explanations such as the one offered by the National Institute of Clinical Excellence (NICE) guidelines on self-harm (NICE 2004a: 16) ‘Self-poisoning or injury, irrespective of the apparent purpose of the act’, to longer definitions, for example the one used by the World Health Organization in 1989 (Platt et al. 1992: 92):

An act with an non-fatal outcome in which an individual deliberately initiates a non-habitual behaviour that, without intervention from others will cause self-harm, or deliberately ingests a substance in excess of the prescribed or generally recognised therapeutic dosage and which is aimed at realising changes which the subject desired via the actual or expected physical consequences.

However, the International Child and Adolescent Self-Harm in Europe (CASE) study group (Madge et al. 2008) utilize a working definition whereby self-harm is seen as an act with a non-fatal outcome in which one or more of the following behaviours are present:

• Ingesting a substance in excess of the prescribed or generally recognized therapeutic dose
  
• Ingesting a recreational or illicit drug which was an act that the person regarded as self-harm
  
• Ingesting a non-ingestible substance or object
  
• Any initiated behaviour that an individual intends to cause harm to self. For example, deliberately cutting oneself, jumping from a height, self-inflicted cigarette burning, wound excoriation and mutilation of the face or other body parts.

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