Assessment of adolescent self-harm

This practitioner review suggests an approach to adolescents who harm themselves, principally by self-poisoning or self-cutting. Such adolescents frequently pass through the care of paediatricians, who may feel that they are not trained adequately to help them. The presentation of self-harm to health professionals provides an important opportunity for secondary prevention of repeated self-harm and suicide. To achieve this, all those in contact with such adolescents need to be aware of the pain and distress that lead them to a position where self-harm seems the best coping strategy. The practicalities of engagement, history-taking, observation and what to do next are discussed. Although informed by the latest guidelines, research and psychiatric understanding, the review is intended to be a practical guide based on personal experience.