People who self-harm could be advised on how to inflict pain on themselves "safely" under plans being considered by the Department of Health.

A consultation document circulating among mental health doctors and nurses, seen by the Guardian, suggests that "the climate is right" to discuss safe self-harm for some patients because of concerns that trying to prevent people from cutting themselves is failing. Trying to stop self-harming against a patient's wishes conflicts with NHS policy to offer "choice".

Health department officials are monitoring a pilot scheme at St George's psychiatric hospital, South Staffordshire. Chris Holley, the consultant nurse in charge of the scheme, said it was not a matter of handing out clean razor blades, but trying to make it safer for patients. People are encouraged to use ice cubes to freeze their skin or elastic bands to flick themselves with instead of cutting. "For some people it's crucial to help them cope and even avoid suicide," Ms Holley said.

Nurses negotiate with patients how often and where they might harm themselves and ensure they do it cleanly to avoid infections. All patients are also undergoing psychotherapy.

However, Katherine Murphy, of the Patients Association, said: "Why shouldn't we have the resources available to support them as opposed to saying it's OK to self-harm?"