Commentary. Patrick Sullivan's emphasis on the importance of supporting autonomy and independence among vulnerable people who self-injure is fundamental to good clinical practice. Although people who self-injure typically experience overwhelming emotions and may be prone to impulsive behaviour, self-injury is nonetheless a choice and must accordingly be treated as such.1 In addition, patients who self-injure when not acutely mentally ill typically retain decision-making capacity in relation to self-injury.2 This is why some forms of harm minimisation, such as encouraging reflection, responsibility, safe cutting and where appropriate self-aftercare, are uncontroversial and already widely practised within community settings. The situation is different, however, with respect to both secure and non-secure inpatient settings....To read the full article, log in using your NHS OpenAthens details.