Abstract
The connection between substance abuse and self-harm has been well recognized in the literature for some time, and may even be the basis for rising youth suicide rates [Citation]. However, this knowledge is not always reflected in clinical practice. When psychiatric assessments are made of suicide attempters the contribution of substance abuse is often passed over quite lightly. Of even greater concern is the general lack of skills and focus on management of self-harm in specialized drug and alcohol services, despite their high-risk clientele. Furthermore, these services often experience difficulty in accessing psychiatric support.