Problems reported by self-harm patients: perception, hopelessness, and suicidal intent.

OBJECTIVE Research suggests that problem-solving therapy may be an effective intervention following self-harm. This study determines the relation between self-harm patients' perceptions of their problems and their expressions of hopelessness and suicidal intent. METHOD One hundred fifty patients admitted to a district hospital following self-harm were asked questions about the type and perceived solubility of their problems. In addition, in each case, the patient completed a Beck's hopelessness scale and a psychiatrist completed a Beck's suicidal intent scale. RESULTS 66% of patients, and more of the males than of the females, recorded at least one problem that they believed to be insoluble; such problems were most often in the area of relationships. Patients who reported insoluble problems experienced higher levels of hopelessness and more suicidal intent. There was significant correlation among the number of insoluble problems, hopelessness, and suicidal intent. CONCLUSIONS People who undertake self-harm report insoluble relationship problems. When assessing hopelessness and suicidal intent in self-harm patients, clinicians should ask about perception of insoluble problems.