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Like With All Aspects Of Health Care, And Particularly Mental Health Care, ...

Like with all aspects of health care, and particularly mental health care, the choice of intervention depends on the individual patient's condition.
Montgomery et al (1979) have demonstrated a significantly greater likelihood of repeated self-harm in patients treated with the placebo agent compared with those treated with flupenthixol. Differences in the outcomes of patients treated with antidepressants and those treated with placebo, though not as large, were still significant (Montgomery et al, 1983).
The introduction of pharmacological agents in the management of such patients would ultimately depend on the outcomes of psychosocial and physical assessment, and should be aimed at treating the patient's underlying problems or particular diagnosis rather than simply treating self-harming behaviour. Whatever, therapeutic decisions are made, clinicians should ensure that the patient (or where not possible, parents or guardians) are made aware of the treatment options available, including the likely advantages and disadvantages, and involved in making a choice.
2.1.7 Referral and Discharge Following Self-Harm
Referral and discharge of an adolescent after self-harm would depend on the outcomes of the extensive assessment that would have been previously conducted (section 2.1.1). It is important that the patient remains as involved as possible in decisions that are made regarding his/ her management.
Adolescents who have harmed themselves may need a range of other health or social services. Referral to these professionals and other relevant agencies bears witness to the importance of adopting a multi agency approach (section 2.3). Proper documentation of all relevant interventions and conversations will ensure a seamless transfer from one health service to another and culminate in improved quality of care and better outcomes.
2.1.8 Family Support
This is quite different from family therapy as discussed under treatment options (section 2.1.4). Rather than attempt to resolve underlying family problems in a bid to address the source of the adolescent's problems like the latter, family support refers to moves that could be taken to help parents and siblings deal with the traumatic experience of self-harm in the family.
Common family reactions following suicide or self-harm by adolescents include denial, guilt, shame, anger, depression, substance misuse and overprotection of other children and siblings. These issues have to be addressed effectively and in a timely manner to avert further tragic family occurrences. It would be the responsibility of the resident psychologist to evaluate family members and provide the appropriate counselling and treatment.
2.1.9 Prevention
A large part of responding to the increasing rates of self-harm among adolescents in the UK is initiating preventive measures.

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