Abstract

Abstract:

Self-injury is a complex phenomenon that is encountered on a regular basis in mental health care, in both hospital and community settings. This article applies the concept of epistemic injustice as a means of understanding some of the problems associated with supporting people who self-injure. It will be argued that people who self-injure may be subject to both testimonial and hermeneutical injustice and this can impact negatively on the care they receive. If we respect their position as a source of knowledge, this can have significant clinical implications. I use the development and introduction of harm minimization techniques into this area of clinical practice as an example and argue that this provides an illustration of how respecting an individual's capacity as a 'knower," can have a direct impact on clinical care. Respecting the perspective of those who have lived experience of self-injury has resulted in different ways of understanding self-injury and led to the development of more innovative and less restrictive ways of working. I take the position that we must be constantly vigilant to the possibility of epistemic injustice because its presence has a negative impact on the quality of care provided. I end my analysis with a note of caution about the progress made so far.

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