In a sample of 242 women in treatment for severe mental illness (SMI), we used regression analysis to test the hypothesis that lifetime physical and sexual abuse would correlate with self-harm behaviors (thoughts of self-harm and suicide, self-harming behaviors, and suicide attempts) when controlling for psychiatric symptoms, substance abuse, and negative appraisals of trauma. Lifetime physical abuse and alcohol use were the only significant factors in the model. Women with SMI should be screened regularly for physical abuse, alcohol use, as well as thoughts and behaviors related to self-harming behaviors. Limitations of the study include its cross-sectional design.