Journal of Psychiatric and Mental Health Nursing, 2007, 14, 64–71 64 © 2007 The Author. Journal compilation © 2007 Blackwell Publishing Ltd O’DONOVAN A. (2007) Journal of Psychiatric and Mental Health Nursing 14, 64–71 Pragmatism rules: the intervention and prevention strategies used by psychiatric nurses working with non-suicidal self-harming individuals Self harm in the absence of expressed suicidal intent is an under explored area in psychiatric nursing research. This paper reports on findings of a study undertaken in two acute psy- chiatric inpatient units in Ireland. The purpose of the study was to gain an understanding of the practices of psychiatric nurses in relation to people who self harm, but who are not considered suicidal. Semi structured interviews were held with eight psychiatric nurses. Content analysis revealed several themes. For the purpose of this paper the prevention and intervention strategies psychiatric nurses engage in when working with non-suicidal self harming individuals are presented. Recommendations for further research are offered. Keywords: acute psychiatric inpatient unit, intervention, non-suicidal, safety, self harm, prevention Accepted for publication: 6 October 2006 Blackwell Publishing LtdOxford, UKJPMJournal of Psychiatric and Mental Health Nursing1351-0126© 2007 The Author. Journal compilation © 2007 Blackwell Publishing Ltd 20071416471Original ArticlePragmatism rulesA. O’Donovan Pragmatism rules: the intervention and prevention strategies used by psychiatric nurses working with non-suicidal self-harming individuals A. O’DONOVAN RPN BNS ( H ons) MS c Lecturer, School of Nursing and Midwifery, University College Cork, Cork, Ireland Correspondence: A. O’Donovan School of Nursing and Midwifery University College Cork Cork Ireland E-mail: aine.odonovan@ucc.ie Introduction Self-harm in the absence of expressed suicidal intent is an under-explored area in psychiatric nursing research. Harris (2000) has argued that this form of self-harm, described by Fontaine (2003, p. 221) as ‘the deliberate destruction of body tissue without conscious intent of suicide’, is a dis- tinct field which needs to be separated from suicide and parasuicide. The motives or reasons for this behaviour are different and, therefore, the needs of this population are different. Additionally, it has been recognized that there is a higher suicidal intent with overdose (Harriss et al. 2005); therefore, this behaviour should be separated from the type of self-harm discussed above. While studies have been reported upon which have explored psychiatric nurses’ and service users’ views of the care provided to suicidal indi- viduals, such as those by McLaughlin (1999), Long & Reid (1996) and Fletcher (1999) only a few, for example, Smith (2002) and O’Donovan & Gijbels (2006) have focused on self-harm in the absence of expressed suicidal intent. There- fore, little is known about the way psychiatric nurses engage in care with people who self-harm in the absence of expressed suicidal intent or whether their practice is differ- ent depending on intent. This paper adds to this, as yet, limited body of knowledge, by reporting on the prevention and intervention strategies, which psychiatric nurses, working in acute psychiatric inpatients units in Ireland, adopted in working with people who self-harm in the absence of expressed suicidal intent. Literature review Four main issues were taken into account in examining the self-harm prevention and intervention research and theo- retical literature. The first one refers to terminology. It has been acknowledged (Hawton et al. 1997, O’Donovan & Gijbels 2006) that many terms are used interchangeably to describe self-harm, including such terms as self-mutilation, parasuicide, deliberate self-harm, self-injury, self-directed violence and attempted suicide. Hawton et al. (1997) add