by Stella O’Malley, UnHerd
When a whistleblower claimed that the charity LGBT Youth Scotland had advised teenagers to use sterilised blades if they were self-harming, the reaction was a mix of horror and disbelief. How can a youth advocacy organisation condone such behaviour under the guise of safeguarding? And, more disturbingly, has this sort of advice become common practice?
Self-harm among adolescents and young adults is one of the defining mental health challenges of our time. Between April 2022 and March 2023, there were 73,239 emergency hospital admissions for intentional self-harm in England, equating to a rate of 126.3 per 100,000 people. While the numbers are widely reported, less scrutiny is given to how professionals should respond. Harm-minimisation strategies, which were once a last resort, are now sliding into the mainstream. With them comes a moral dilemma: when does seeking to reduce harm morph into enabling behaviour?
To some, harm minimisation is common-sense pragmatism. It accepts that stopping self-harm may not be realistic in the short term, so instead encourages safer behaviours while deeper therapeutic work begins. This might mean holding ice cubes, snapping rubber bands, or punching pillows. More controversially, it can involve guidance on how to self-harm “safely”: use clean blades, avoid arteries, treat wounds. To others, though, it sounds like a dangerous normalisation of self-mutilation.