Suicide and self-harm offender-specific screening tools

While the terms suicide and self-harm are often used interchangeably, it is important to be clear that they are conceptually different. Suicide is a self-inflicted act with the intention to cause death, whereas an act of self-harm may be the precedent to an act of suicide, but it can also exist as a concept in its own right as an intentional act of harm without suicidal intent. Self-harm is intentional, often repetitive, and often constitutes a coping mechanism to provide temporary relief from emotional distress. The crucial differentiation between suicidal behavior and self-harm lies in the nature of motivational intent underlying the action. This distinction makes the early identification of those who are at risk of self-harm or suicide more difficult and the screening of potential at-risk populations more complex. It has been argued that as the impact, treatment pathway, and even costs are similar for both groups, this difference is considered irrelevant for the screening of these behaviors. Skegg in 2005 suggested that self-harm and suicide should be considered as a continuum in the sense that self-harm covers a spectrum of behavior: The most serious form closely relates to suicide, while behaviors at the milder end of the spectrum range merge with other reactions to emotional pain. And it is this approach most commonly employed in the development of screening tools to identify those at risk of suicide and self-harm, whereby self-harm is defined as an act of self-poisoning or self-injury, irrespective of the purpose of the act. This entry addresses the prevalence of suicide and self-harm in offender populations, lists risk factors for offender suicide and self-harm, and provides an overview of assessment tools.