Treatment recommendations: （i） Organization of general hospital services to provide:emergency department admission; a safe environment; integrated medical and psychiatricmanagement; risk assessment; identification of psychiatric morbidity, and adequate follow-up. （ii） Detection and treatment of any psychiatric disorder. （iii） Dialectical behaviour therapy,psychoanalytically orientated partial hospitalization or home-based interpersonal therapy（for certain patients） to reduce repetition of deliberate self-harm （DSH）。

    Conclusion: Deliberate self-harm is common and is costly in terms of both individualdistress and service provision. General hospitals are often the first point of clinical contact, butmay not be appropriately organized to care for these patients. Evidence for the effectivenessof psychological treatments is based on single RCTs without replication. The three recom-mended psychological treatments are not widely available in Australia and New Zealand, andthe interventions that are, such as cognitive behaviour therapy, problem solving and 'greencards' （an agreement guaranteeing access to services）， do not reduce repetition of DSH. Theeffect of follow-up in psychiatric hospitals or in the community is poorly understood. We needto develop and evaluate interventions that will reduce repetition of both fatal and non-fataldeliberate self-harm and improve the person's functioning and quality of life.Key words: attempted suicide, deliberate self-harm, overdose, self-injury, self-mutilation,self-poisoning.

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