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Letters Managing self harm

Authors’ reply to Ellis and Yates

BMJ 2012; 344 doi: (Published 10 January 2012) Cite this as: BMJ 2012;344:e144
  1. Navneet Kapur, chair of the Guideline Development Group and professor of psychiatry and population health1,
  2. Tim Kendall, director of NCCMH and medical director, Sheffield Health and Social Care Trust2,
  3. Clare Taylor, senior editor2,
  4. Melissa Chan, systematic reviewer2,
  5. Henna Bhatti, research assistant2
  1. 1University of Manchester, Manchester, UK
  2. 2National Collaborating Centre for Mental Health (NCCMH), UK
  1. nav.kapur{at}

Ellis and Yates highlight the recommendations on risk scales.1 2 3 A central question is whether healthcare professionals should be able to accurately predict adverse outcomes after self harm. The literature review carried out for the guideline suggests that this is not a realistic aim.4 After a first self harm episode, most people will not repeat self harm or die by suicide.5 Identifying those who will have a poor outcome …

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