Suicide and Self-Harm: Helping People at Risk

I no longer use the term “self-harm” when working with clients. As the Suicide Prevention Supervisor for Wellstar Health System (2020-2023) in Marietta, Georgia (Cobb County), I learned about the CDC’s classification system for Self-Directed Violent Behavior (SDVB). If you work with me, that will be the phrase I use.

Word choice matters. Some people don’t view their self-inflicted violence (SDV) as causing “harm.” Not all self-directed violence causes an injury. Not all self-directed violence is mutilation. If I ask a client if they’ve injured themselves, they might say no, despite having engaged in some sort of self-directed violent behavior. Also, not all self-directed violence is suicidal in nature.

Instead of engaging in a power-struggle, which often increases feelings of shame, I do not shy away from conversations about self-directed violence. If we don’t talk about it openly, we can’t engage in harm reduction. Earlier in my career I worked at Salt Lake County Division of Youth Services in Utah, and we had a mantra: “All behavior is an attempt to meet a need, and therefore has meaning.” I want to understand what happens that causes a client’s SDV and discuss steps to prevent harm (injury, infection, etc.) 

We will also work together to develop a safety plan- a tool for coping and decreasing risk of intentional or accidental death. Research has shown that when done well, safety plans keep people alive.