Does self-harm not qualify for IHSS protective supervision?

Intentional self-harm does not qualify for protective supervision, but how do you define intentional self-harm? For example, if a child is banging their head for sensory input or hitting themselves for sensory input, are they intending to hit themselves? Maybe. Are they intending to make contact between their head and a surface? Maybe. But do they understand that they could hurt themselves that way, as opposed to somebody who is potentially suicidal, and their goal is to hurt themselves? There's a difference between they intended to do the thing, but they didn't know that they could hurt themselves doing it, and they intended to hurt themselves.

The classic example of self-direction is if a child throws a ball into the street and then runs after the ball without thinking or without looking around. They're self-directed as far as they intended to chase the ball and get the ball. That's what they intended to do, but for IHSS purposes, they're not self-directed in terms of running into the street. If the child should know at that age that they need to look both ways before they cross the street, but they just run into the street because they're not able to understand that running into the street could potentially cause them harm, then that is an example of where their cognitive deficit is causing the potential for harm. Even if they knew that the ball was in the street and their goal was to go get the ball, if they didn't understand that a car could come, then they weren't able to assess the risk.

So with self-harm, there are plenty of things that people do that they intended to do, like climb furniture or try to get a toy that's out of reach, but if they didn't understand that they could be hurt that way, then that's not intentional self-harm.

For more information, see our article on IHSS protective supervision.