Impatient and Crisis Working Flashcards
When risk assessing /care planning in an inpatient wards what should we consider?
-Gather information - collateral info, clinical interview with service-user, interview with family, staff
-Determine presence of risk factors
-Develop formulation of risk
-Develop scenarios of future risk – when might risk increase / decrease?
-Develop care plan to reduce risk
What are some of the static risk factors of suicide?
-Prior suicide attempt or deliberate self-harm (including suicide attempt at time of admission)
-Psychiatric diagnosis and/or history of psychosis especially co-morbid diagnosis of Schizophrenia & –depressed mood
-Family history of serious psychiatric problems or suicide
-Number and duration of prior psychiatric admissions
-Physical and/or terminal illness
-History of substance use/ misuse
-History of socio-economic deprivation
-Prescribed antidepressants (the prescription of antipsychotics is not significantly correlated with suicide risk)
-Admitted under the Mental Health Act
Warning of suicidal intent, suicidal ideation & evidence of a specific plan for suicide
-Recent Stressful Life Event
-Recent bereavement or relationship breakdown
-Being a widow/widower
What are some of the clinical/modifiable risk factors for suicide?
-Evidence of persecutory voices/beliefs
-Evidence of depression/loss of interest or loss of pleasure
-Delusional ideas
-Evidence of withdrawal
-Presence/Influence of hopelessness
-Living alone
-Unemployment
-Social or relationship problems
-Suicidal ideas
-Agitation or anxiety
-Feelings of worthlessness, inadequacy or guilt
What are some of the situational/demographic characteristics of those in an inpatient ward?
Significant mental health difficulty
Racial inequalities
Disempowered
Current risk of harm to self /others
High rates of socio-economic disadvantage
High rates dependant on social security
High rates of substance misuse
High rates of impaired cognitive functioning
Very high threshold for admission – RISK RISK RISK
