The Self Injury Bill of Rights

WARNING-The following content may be offensive and sensitive to some.

This is something that may sound drastic and manipulative, but for some with a severe mental illness, this is their only way to cope. It is often a last ditch effort before committing suicide.

1) The right to caring, humane medical treatment;

Self injurers should receive the same level and quality of care that a person with an identical but accidental injury would receive. Procedures should be done gently as they would for others. If stitches are required, local anesthesia should be used. Treatment of accidental injury and self-inflicted injury should be identical.

2)The right to participate fully in decisions about emergency psychiatric treatment (so long as no one's life is in immediate danger);

When a person presents at the emergency room with a self-inflicted injury, his or her opinion about the need for a psychological assessment should be considered. If the person is not in obvious distress and is not suicidal, he or she should not be subjected to an arduous psych evaluation. Doctors should be trained to assess suicidally/homicidal and should realize that although referral for outpatient follow-up may be advisable, hospitalization for self-injurious behavior is rarely warranted.

3) The right to body privacy;

Visual examinations to determine the extent of injury should be performed only when absolutely necessary and done in a way that maintains the patients dignity. Many who SI have been abused; the humiliation of strip-search is likely to increase the amount and intensity of future self-injury while making the person subject to the searches look for better ways to hide the marks.

4) The right to have the feelings behind the SI validated;

Self-injury doesn't occur in a vacuum. The person who self-injures usually does so in response to distressing feelings, and those feelings should be recognized and validated. Although the care provider might not understand why a particular situation is extremely is upsetting, she or he can at least understand that it *is* distressing and respect the self-injurer's right to be upset about it.

5) The right to disclose to whom they choose only what they choose;

No care provider should disclose to others that injuries are self-inflicted without obtaining the permission of the person involved. Exceptions can be made in the case of a team-based hospital treatment or other medical care providers when the information that the injuries were self-inflicted is essential knowledge for proper medical care. Gossiping about any patient is unprofessional.

6) The right to choose what coping mechanisms they will use;

No person should be forced to choose between self-injury and treatment. Outpatient therapists should never demand that clients sign a no-harm contract; instead, client and provider should develop a plan for dealing with self-injurious impulses and acts during the treatment. No client should feel like they must lie about SI or be kicked out of outpatient therapy. Exceptions to this may be made in hospital or ER treatment, when a contract may be required by hospital legal policies.

7) The right to have care providers who are not afraid of SI;

Those who work with clients who self-injure should keep their own personal fear, revulsion, anger, anxiety, etc. out of the therapeutic setting. This crucial for basic medical care of self-inflicted wounds but holds for therapists as well. A person who is struggling with self-injury has enough baggage without taking on the prejudices and biases of their care providers.

8) The right to have the role of SI has played as a coping mechanism validated;

No one should be shamed, admonished or chastised for having self-injured. Self-injury works as a coping mechanism, sometimes for people who have no other way to cope. They may use SI as a last-ditch effort to avoid suicide. The self-injurer should be taught to honor positive the positive things that self-injury has done for them, while recognizing that the negatives of SI far outweigh those positives and that it is possible to learn methods of coping that aren't as destructive and life-interfering.

9) The right not to be automatically considered a dangerous person simply because of self-inflicted injury;

No one should be put in restraints or lockedin a treatment room in an emergency room soley because his or her injuries are self-inflicted. No one should involuntarily committed because of SI; physicians should make the decision to commit based on presence of psychosis, suicidiality, or homicidiality.

10) The right to have self-injury regarded as an attempt to communicate, not manipulate.

Most people who hurt themsleves are trying to express things they can say in no other way. Although sometimes these attempts to communicate seem manipulative, treating them as manipulative only makes the situation worse. Providers should respect the communicative function of SI and assume it is not manipulative behavior until there is clear evidence to the contrary.

I know there are alot of people with a mental illness that do self injure to a point where medical attention is required. I know first hand the stereotype and the judgments from others when self-injury is applied as a coping tool.
I found this info at realmentalhealth.com. I posted this because of the relevance of this topic and the topic of mental illness.
There are alot of moral, emotional, psychological, and physical issues when dealing with the matter. Especially for the family of a self injurer. Sometimes family members have moral obligations to see their loved one will not injure themselves. Other times it is used as a curtain to ignore the family member and to isolate the person doing the self injury.
I recommend anyone that is self injuring themselves to seek counseling. If insurance is an issue, there are always hospitals that can place you with crisis intervention.
I feel that self injury is a huge sign an intervention needs to take place.