Self-mutilation is a more common behavior than generally realized; its prevalence may be 750 per 100,000. From the responses of 250 subjects to a Self-Harm Behavior Survey we have learned that self-mutilation typically begins in early adolescence and may assume a chronic course characterized by severe psychosocial morbidity. Some chronic self-mutilators already are heavy and generally dissatisfied users of mental health services. The number of them seeking help may increase as a result of heightened public awareness. Community mental health facilities may be hard-pressed to meet the needs and demands of these clinically vexing patients.