Training Hospital Staff on the Psychological and Emotional Needs of Self-Harm Patients

In a new report published in the Journal of Psychiatric and Mental Health Nursing, researchers assess 19 individual papers spanning ten years and four countries to assess how well medical staff is prepared for dealing with patients admitted for injuries that were self-inflicted. Most common were patients who had cut themselves or who had attempted to commit suicide. The study concluded that hospital staff, especially the nurses responsible for direct care of patients, were inadequately trained for the unique needs of patients who had self-harmed. Staff also reported that attitudes and misconceptions about these patients likely contributed to the patient’s negative experience, and to that nurse’s negative perception of his or her ability to provide adequate care and support.

Any patient admitted to a hospital has not only physical but also emotional and psychological needs. Dealing with an injury or an illness can be overwhelming. But in the case of people who have enacted self-harm, the causal relationship goes the other way: their overwhelming thoughts and feelings were the cause of the injury. In this way, such patients need a type of care and sensitivity that is unique. Yet of those nurses and doctors surveyed, the percentages that had received training on the specialized needs and situations of these patients were quite low: 21 percent in Australia and nine percent in the UK.

Mental health stigma also plays a role in how well these patients are treated in the hospital. For example, of the Australian ER nurses surveyed, 88 percent “had heard other staff make negative statements about patients who had self-harmed.” These attitudes, intentionally or not, may easily influence the interactions between staff and patients. According to the report, training the hospital staff on the psychological and emotional landscape of self-harm (both leading to and stemming from the act itself) resulted in increased confidence, better understanding, and greater empathy toward patients. A nurse is not a therapist or psychologist, but working to educate them on even the basics of psychological health as related to self harm can make a significant and positive difference on patients’ experience while in the hospital.

© Copyright 2010 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Lynette


    September 30th, 2010 at 10:46 AM

    I had a friend that was a nurse and I know that negative attitude you speak of, intentional or not, was how she felt. She resented having to spend time working with them because it was self-inflicted. It took her away from other patients that were there through no fault of their own, with heart attacks and so on. That was her complaint.

  • Robin


    September 30th, 2010 at 1:09 PM

    Lynette,I completely understand you friend’s complaint and as someone who has been associated with medical field himself,I can say that as a nurse(or any other medical personnel),it becomes more of a duty for her to treat all patients equally and to look after all of them.

    Yes,there are people who inflict some harm but its not for nothing that they do that,isn’t it?!

  • Josh


    September 30th, 2010 at 1:27 PM

    I’ll never get how hurting yourself can make you feel better. Why does it? I’m seriously curious.

  • helena


    September 30th, 2010 at 2:20 PM

    Because it’s a release of pent-up emotion. It’s not the most healthy way to do that, given the risk of infection alone, but that’s what it is. That’s a very simplistic explanation to a very complex question.

  • gillian M.

    gillian M.

    September 30th, 2010 at 5:35 PM

    it may be because they just cant take things anymore…life has dealt them too many a blow and they are not able to take it any longer…we should all be sensitive to such people and it is very important for hospital staff to be.

  • jocelyn


    September 30th, 2010 at 5:59 PM

    People shy away from cutters and discussing the reasons behind it. They don’t understand it so they don’t talk about it. There needs to be more openness. The acceptance that cutters need help just the same as does a person with for example schizophrenia or depression apparently isn’t there and that’s very sad.

  • Johnna


    October 1st, 2010 at 4:51 AM

    You would think that the health care professionals who have chosen to work with these kinds of patients would naturally have a built in sympathy and empathy for the patients, and would want to learn why what happened did happen and the best way to offer treatment to them. I always have these high minded standards that the people caring for me in the hospital would be caring and educated enough to be able to look at what was going on with me objectively and not to make judgements based on situations with which they are not necessarily familiar. Guess I am completely wrong on that one. And it is hard to know what you get when you hire people because some people will say what they think you want to hear just to get the job.

  • Catherine


    October 2nd, 2010 at 5:02 PM

    Remember that that person who is self-harming is someone’s son, daughter, brother, sister. Alienation solves nothing. Look beyond the action itself and see the person who is crying out for help behind it.

  • Sebastian


    October 2nd, 2010 at 6:26 PM

    Nurses who treat one patient one way and another a different way because of their condition shouldn’t be nurses. There are bad nurses the same as there are bad engineers or bad bus drivers. I was in hospital once for appendicitis and saw how different the nurses can be. There are angels and there are devils.

  • Ivan


    October 3rd, 2010 at 11:23 AM

    Any and all patients should be treated with dignity. I don’t care if your reason for being hospitalized is physical, mental or a combination of both. You are a human being and deserve that basic right and quality of care. I’m sure if you looked at the mission statement or patient’s charter of any hospital it will say something similar. Hold them to those words and make them prove that it’s not just empty words in a pretty frame. We as patients are not without power.

  • Opal


    October 4th, 2010 at 5:13 PM

    I’m glad nurses are being trained to look at these vulnerable folks with fresh eyes. That’s excellent news.

  • natasha


    October 4th, 2010 at 8:17 PM

    Nurses are human beings too you know. They can’t help their own emotions and biases from arising, even unconsciously, any more than you could your own in a different situation. They work extremely hard and under enormously stressful working conditions. Can you blame them for wanting to attend to the father of three and grandfather of twelve that’s had a life threatening stroke more than the goth girl who thinks cutting is cool and thought she’d try it?

  • jason c.

    jason c.

    October 6th, 2010 at 11:05 AM

    Feeling judgmental are we? Stereotyping cutters is almost as damaging as the cutting itself! You don’t know why kids cut and you don’t know that every nurse would choose the father over the kid to attend to. Kids that cut are obviously disturbed in some way. They need compassion, mental help and understanding. You can’t say that one person’s needs are more important because of their family status.

  • Isabel


    October 6th, 2010 at 4:34 PM

    I think anybody that comes into a hospital with a deliberately self-inflicted injury should go to the back of the queue.

  • starr


    December 25th, 2010 at 5:16 PM

    You have no right to judge I’m a cutter and it hurts to have complete strangers think I’m evil my own family don’t understand if my mom knew she would disaprove icry into my pilow every night wishing someone woul ask me what’s wrong I’m not doing it for attention I’m not proud of what I do its the only way I know how to numb my self from the pain in my heart I want to stop I want help but I’m afraid of being regected and pepole looking and treating me like a freek I want some one to care to love me for what I am .

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