Deliberate Self Harm

Research has shown that episodes of deliberate self-harm (DSH) typically occur soon after arrest. Particular risk factors include a history of DSH and a psychiatric history (25,26). Medical assessments should be requested for those detainees who give a clear intention of DSH, with attention given to any visible evidence of previous DSH acts.

If a detainee commits a DSH act, a medical assessment should be conducted irrespective of whether there has been any physical injury, and an attempt should be made to assess the risk of suicide. When the risk is believed to be high, then referral to a hospital is required, and the detainee should be kept under constant supervision until such transfer is arranged. When the risk is deemed to be low, clear instructions must be given to the police regarding care and supervision. The police may consider removal of the detainee's cloth ing and personal effects to prevent self-harm. Cells should be checked with respect to their structural integrity to prevent any defects being used for DSH, and bedding should be of an appropriate standard.

Liaison between agencies is essential, and when the detainee is transferred to prison, another police station, or hospital, details regarding the DSH incident should be passed to the custody or hospital staff concerned so they can take appropriate precautions.

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