ABSTRACT
Para-suicidal behaviours and self-harm are commonly observed in mental health institutions, with women inpatients being particularly at risk. Little research has looked at characteristics of women engaging in self-harmful conduct beyond diagnostic and socio-demographic information. The current study investigated occurrences of self-harm over time in a large sample of women housed in forensic mental health units in the province of Ontario, Canada. Background and clinical information was obtained from staff ratings on the Resident Assessment Instrument—Mental Health at admission and every 3 months afterwards for an approximately 2-year time period. Latent class mixed models identified two distinct profiles, the first one (77.4% of sample) characterised by a low or intermittent use of self-harm, the second (22.6% of sample) showing a stable elevated risk profile. Women in the at-risk group tended to be younger, showed increased signs of subjective distress and greater occurrence of adverse life events in their history. Psychiatric diagnosis in itself was not a valid predictor of the stability of self-harm for this sample. These findings highlight the importance of addressing both clinical and stress-related distal vulnerability factors in the background of institutionalised women who engage in self-harm on a stable basis.