My client self harms - slashing at himself usually with scissors. He was turned down for DLA and the submission on appeal shows the reason as that the injuries he inflicts on himself are minor. Does anyone know of any caselaw dealing with what ammounts to 'substantial' danger or have any info on whether this kind of self injury has the risk of doing more harm than a few cuts?

Thanks

From the Derbyshire Caselaw pack: CSA/68/89 on reducing the risk of neglect or self injury, also R(DLA)10/02 and CA/177/1998, and R(A)1/73 - 'substantial danger' should not be too narrowly construed.

i suppose 'could have used a chain saw' makes a change from 'could use a slotted spoon'...jeez...

Unless he's an expert on anatomy it's possibly more luck than judgement that he hasn't hit a vein or artery yet!

Not caselaw, but something that may be just as useful;

1) The risk of "unintentional" self-harm - ie cutting deeper (possibly hitting a vein) than intended.

2) The risk of infection if cuts are not cleaned/treated properly.

3) The important one - the established link between self-harming behaviour and the significant and persistent risk of subsequent suicide - something with which to demolish the assumption that it is "only" cutting. A recent report (2003 British Journal of Psychiatry, reprinted BMJ 2005) showed that those who self-harm are some 66 times more likely to commit suicide than the general population and that this risk persists for upwards of 15 years. Usefully for you, that risk is also significantly higher amongst male self-harmers.

Link: http://bjp.rcpsych.org/cgi/reprint/185/1/70

I've used this very recently to win a continual supervision/watching over/high rate care case on the basis of reasonable requirement. Might be of use, possibly even in instances where the claimant isn't presently experiencing (or admitting to experiencing) suicidal ideation.

(ps - if you can't get the link to work for some reason, just google "suicide and self-harm")

that's a really helpful link - thanks

just one more thought - if there's any question of blood transmissable disease being present, there could arguably be a substantial risk to others... e.g. if someone uses a household knife etc. (and vice versa of course)

also some of the people who cut themselves that I've worked with avoid seeking medical help (not only for the cuts but for anything else) because of shame about scarring and or judgemental responses they've received in the past.