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Interventions to prevent self-harm: what does the evidence say?
  1. Kate E Saunders1,2,
  2. Katharine A Smith1,2,3
  1. 1Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK;
  2. 2Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK;
  3. 3NIHR Oxford Cognitive Health Clinical Research Facility, Warneford Hospital, Oxford, UK
  1. Correspondence to Dr Kate E Saunders, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK; kate.saunders{at}


Self-harm is a major public health concern and a risk factor for future suicide. It predominantly occurs in young people with around 65% of self-harm occurring before the age of 35. Self-harm causes distress to families and is associated with poorer educational outcomes as well as increased health and social care costs. Repetition is common with a quarter of individuals presenting to hospital with a further episode of self-harm within a year. We review the evidence from randomised controlled trials of treatments for self-harm, focusing on pharmacological and psychological approaches. We then contrast this with the current observational evidence and reflect on the challenges and limitations of randomised controlled trials for the treatment of self-harm.

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