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Summary Deliberate self harm and poisoning

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This document looks at the causes and effects of DSH and DSP. IT provides examples of what constitutes self harm and the psychological effects

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December 4, 2021
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2021/2022
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Poisoning refers to the development of dose-related adverse effects following exposure to
chemicals, drugs, or other xenobiotics through inhalation, ingestion, skin or eye contact, or
inoculation. The dose makes the poison.

 Includes those who engaged in deliberate self-poisoning with an intent to die as well as
those with no intent to die.

Deliberate self-poisoning (DSP) has been defined by the World Health Organization (WHO) as an act
with a nonfatal outcome in which an individual deliberately ingests a substance in excess of the
prescribed or generally recognized therapeutic dosage. DSP and deliberate self-injury are
subcategories of deliberate self-harm.

 DSP is the most common method of suicide attempt in developed countries and has been
associated with significant morbidity and mortality.

Deliberate self-harm (DSH) describes a situation where a person with apparent consciousness and
willful intent performs painful, destructive and injurious acts upon his/her own body. An act with
non-fatal outcome, in which an individual deliberately initiates a non-habitual behaviour that,
without intervention from others, will cause self-harm, or deliberately ingests a substance in excess
of the prescribed or generally recognised therapeutic dosage, and which is aimed at realising
changes which the subject desired via the actual or expected physical consequences (WHO)

 In South Africa, deliberate self-poisoning occurs commonly amongst black females of child-
bearing age, belonging to the working class and residing in areas with greater likelihood for
psycho-socio-economic problems.

Motives for deliberate self-harm

Although the terms motive and intent are often used as synonyms in suicide literature, it is clinically
and theoretically useful to differentiate between these constructs. A motive is the underlying ‘cause
or reason that […] induces action’.10 In contrast, intent describes the planned or desired outcome of
the action taken. A motive is the psychological driver or reason to self-harm, whilst intent
describes the desired outcome of DSH.

Some of the motives for self-harm or self-poisoning include

 Financial concerns

 Marital/romantic relationship issues

 Family conflict

 Illness (medical or psychiatric)

 Bereavement

 Academic concerns

 Unplanned pregnancy

The use of rat poison in South Africa
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