Mental Health Flashcards
Name three risk factors which could lead to suicide
Mental illness - usually depression. Negative life events, psych factors, substance misuse, FHx, physical illness, exposure to suicidal behaviour, being male, loneliness, previous suicide attempts, occupation
For someone who is depressed, what question(s) must you ask?
risk of suicide - ask about/assess risk factors and planning or visualising suicide, (self harm too)
Name two things that can be done in the management of suicide risk
Any from: 1) record information in patient notes clearly, 2) share information if working in a team, 3) make information available to out of hours, 4)follow up with pt regularly to monitor, 5)give pt contact numbers for emergency, 6)reassure and encourage to get in touch, 7) assess whether pt has means for suicide attempt, 8) ask about exposure to self harm and suicide, 9) treat underlying reason (e.g. substance misuse), 10) refer to secondary mental health services if high risk.
Define self harm
Self-harm refers to an intentional act of self-poisoning or self-injury, irrespective of the motivation or apparent purpose of the act, and is an expression of emotional distress.
Note: Self-harm includes suicide attempts as well as acts where little or no suicidal intent is involved (for example, where people harm themselves to reduce internal tension, communicate distress, or obtain relief from an otherwise overwhelming situation).
Give an example of indirect self harm
Using too much alcohol or drugs, unsafe sex, physical harm such as bingeing or vomiting in an eating disorder
In a presentation of self harm, who is more at risk? Give two characteristics of a patient more at risk of SH
Woman 16-34 or man 25-34. Person at socio-economic disadvantage. Prisoner, asylum seeker, veteran of armed forces, LGBTQ, past exposure of self harm and suicide, PMH of trauma - emotional, sexual, physical. Substance misuse, chronic illness
Why might a pt self harm?
Gives pt sense of control, reduces feelings of tension and distress, acts as punishment, releases overwhelming emotions.
Name something you would cover when assessing a pt who self harms
Understand reasons for self harm. Reassessment of reason each time they attend. Assess physical injury, emotional and mental state, protective factors and safeguarding concerns. Minimise means of self harm, ensure people involved in care are aware of risk.
How would you manage SH pt who you have assessed as high risk?
Refer to A&E
How would you manage a SH pt you assessed as mild/minor injury with no significant risk?
Treat in primary care
What psychological interventions may you refers a pt with SH on to do?
Psychotherapy or CBT
A person sends in an econsult as they have self harmed. In what time scale should you make contact/see pt?
Within 48hrs
Are suicide and self harm the same? Discuss
SH does not mean suicide - they may not have acted with suicidal intent. Attempted suicide, however, is an act of SH. If a person SHs, they are at increased risk of death from suicide
Describe the symptoms you may see/presentation of depression
low mood, apathy (lack of enthusiasm), low energy, weight changes, libido changes, appetite changes, sleep disturbances, poor concentration, excessive guilt, suicidal ideation, self harm
Name a risk factor for depression
Postnatal - recently having baby. FHx of depression. Dementia. Corticosteroids. Another medical condition.
What is the first questionnaire used in diagnosing depression?
PHQ-2
