The deliberate self-harming behaviour of patients within a British special hospital

Within more conventional discourse amongst health-care professionals, 'deliberate self-harm' is largely conceived in pejorative terms. Unlike other so-called 'pathological' behaviour for which the 'sick' are not held wholly responsible, this particular behavioural mosaic carries within its very conception quite different connotations of 'intentionality'. This project constituted a retrospective survey of the phenomenon amongst patients resident within a British special hospital, over a 6-month period, in 1987, prior to the establishment of a unit for disturbed females in November of that same year. It illustrated that the scale, and nature, of the problem was comparable to any of the other much-publicized accounts that have emerged from other custodial establishments. It is the contention, here, that patient characteristics alone are an insufficient explanation for the level of self-harm that prevails and that significant, alternative considerations are available. It is intended that this paper should contribute to the evaluation of the clients' predicament, and the institutional management of their self-harm, within an environment such as a special hospital in the hope that a clearer understanding, and strategy, may be elaborated.