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Last Updated: Tuesday, 25 April 2006, 14:16 GMT 15:16 UK
Nurses back supervised self-harm
By Nick Triggle
BBC News health reporter in Bournemouth

Young girls
About one in 15 youngsters are believed to have self-harmed
Nurses want to be allowed to let patients who self-harm continue to do so in a safe environment in hospitals.

The Royal College of Nursing is in discussions with regulatory officials about changing nurses' code of conduct.

The move follows news of a scheme in a Staffordshire mental health hospital where adults can keep their blades.

In a debate at their Bournemouth conference, many nurses argued that preventing patients from self-harming made the situation worse.

Controlled self-harm is much, much safer for patients
Jeremy Bore, Exeter prison nurse

Under current rules, nurses feel that are prevented from allowing patients to continue self-harming because they are meant to minimise risk.

But early indications from the pilot at St George's Hospital in Stafford show that allowing self-harm to continue to do so, as part of care plan, can reduce a patient's dependence.

The pilot, which allows patients to keep blades and implements and provides them with cleaning equipment, is not expected to be completed until the end of the year.

But RCN mental health adviser Ian Hulatt said he would be taking the "strong message" heard at the Royal College of Nursing's conference to the Nursing and Midwifery Council.

'Managing feelings'

The majority of nurses supported calls to allow some form of safe self-harm to continue for adult patients who cut themselves.

They pointed out that drug users were provided with syringes and needles to help them use drugs safely.

The debate focussed on adults who self-harm, but nurses also acknowledged children cut and burnt themselves.

Nurses said about 500,000 people self-harm in the UK, some of whom were harming themselves in secret on their thighs, abdomens and arms often in a bid to cope with the trauma of previous abuse or problems.

Nurse consultant Chris Holley, who is involved in the Staffordshire pilot, said: "It is not about all people who self-harm. It is not about handing out cutting implements. It is about people who manage their feelings."

She said for this group of people it was about giving relief and reducing suicidal thoughts.

'Cheap-fix'

Lisa Lester, a nurse from Gloucestershire, said: "Nurses have a critical role in treating the physical and mental health damage and in some cases that may mean allowing safe self-harm."

And prison nurse Jeremy Bore, from Exeter, said it was also a problem in prisons, saying he saw many prisoners who tried to sneak blades into jail by hiding them in their bottoms.

"Controlled self-harm is much, much safer for patients."

But Jenifer Clarke-Moore, of the RCN's mental health practice forum, said: "My concern is that this is leading us up the garden path."

She said allowing self-harm was a "cheap-fix solution" to a complex problem. Instead, she added, "evidence-based interventions which promote health" would be better.




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