Clinical Case Database / Category: Clinical Care

A challenging case of deliberate self harm/self injury in the young adolescent

Publication details

Richard Dickson-Lowe BSc (Hons), MBChB, Kamalakannan Veeramuthu MRCSEd FCEM
Foundation Years Journal, volume 4, issue 10, p.45 (123Doc Education, London, January 2011)


This article gives a brief history of a deliberate self harm/self injury case in 2 young girls followed by a discussion about the management of the patients. Within the discussion a number of important factors will be briefly discussed including Gillick competence, capacity, confidentiality, child protection and the Acts that encompass all these issues (i.e. Mental Health Act, Mental Capacity Act and the Children Act). The reader is advised to refer to Trust and Local or National policies for further information.

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Richard Dickson-Lowe BSc (Hons), MBChB

Senior House Officer
East Surrey Hospital

Kamalakannan Veeramuthu MRCSEd FCEM

Consultant and Paediatric Lead
Emergency Department
East Surrey Hospital


1. Harrington, R. (2001) Depression, suicide and deliberate self harm in adolescence. British Medical Bulletin, 57: 47–60.
2. General Medical Council (2009) Confidentiality. London: GMC. ISBN 978- 0-901458-38-4.
3. Gillick v West Norfolk & Wisbech Area Health Authority [1985] UKHL 7 (17 October 1985) from the British and Irish Legal Information Institute (BAILII) website.
4. Taylor, R. (2007) Reversing the retreat from Gillick? R (Axon) v Secretary of State for Health. Child and Family Law Quarterly, 19(1): 81–97.
5. Mental Capacity Act 2005 (c.9). Part 1 – Persons who lack capacity. Available at Last
accessed 29/09/10.
6. Children Act 1989 (c.41). Section 20 – Provision of Accommodation for Children: general. Viewed at
ukpga/1989/41/part/III. Last accessed 29/09/10.
7. General Medical Council. (2008) Consent: patients and doctors making decisions together. London: GMC. ISBN 978-0-901458-31-5.
8. National Institute for Clinical Excellence, NICE. (2004) Self-harm: the short term physical and psychological management and secondary prevention of self-harm in primary and secondary care. Available at


Conflict Of Interest

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.