Risk assessment and DSH Flashcards
Define para-suicide
Victim survives although suicide was the intention
What is the male to female ratio of suicide?
3:1
What are some risk factors for suicide?
Male Living alone Unemployment Drug/alcohol misuse Mental illness Previous attempt Recent bereavement Delusions Recent inpatient discharge
Define DSH
Act with a non-fatal outcome in which an individual deliberately initiates a behaviour to cause harm to themselves
Give two types of DSH
Self poisoning (ingestion of toxins) Self injury (cutting, burning etc)
Give the areas you should consider when performing risk assessment
DSH or suicide
Harm to others
Self neglect
Exploitation/vulnerability
Could any of the above impact on children?
Could any of the above impact on vulnerable adults?
Could any of the above impact on driving?
What is the driving guidance you should give a patient with depression or anxiety?
If mild to moderate, may continue driving.
If severe, causing significant memory or concentration
problems, agitation, behavioural disturbance or suicidal thoughts, patient must not drive and must notify the DVLA.
Licensing depends on medical enquiries.
What is the driving guidance you should give a patient with an acute psychotic disorder?
Must not drive and must notify the DVLA.
Licensing may be considered once all conditions are met:
- Remained well and stable for 3 months (12 months for HGV)
- Adheres to treatment plan
- Regained insight
- Free from medication effects that may impact driving
What is the driving guidance you should give a patient with STABLE bipolar disorder?
Must not drive and must notify the DVLA.
Licensing may be considered once all conditions are met:
- Remained well and stable for 3 months (12 months for HGV)
- Adheres to treatment plan
- Regained insight
- Free from medication effects that may impact driving
No driving in any acute illness.
What is the driving guidance you should give a patient with UNSTABLE bipolar disorder? (4+ episodes of significant mood swings within last 12 months)
Must not drive and must notify the DVLA.
Licensing may be considered once all conditions are met:
- Remained well and stable for 6 months (12 months for HGV)
- Adheres to treatment plan
- Regained insight
- Free from medication effects that may impact driving
No driving in any acute illness.
What is the driving guidance you should give a patient with schizophrenia?
Must not drive and must notify the DVLA.
Licensing may be considered once all conditions are met:
- Remained well and stable for 3 months (12 months for HGV)
- Adheres to treatment plan
- Regained insight
- Free from medication effects that may impact driving
No driving in any acute illness.
What is the driving guidance you should give a patient with pervasive developmental disorders (Asperger’s, ADHD, , autism)?
May be able to drive but must notify the DVLA.
A diagnosis of any of these conditions is not in itself a bar to licensing.
The DVLA considers factors such the
level of:
- impulsivity
- awareness of impacts of behaviours on self or others.
What is the driving guidance you should give a patient with MCI?
If driving impairment is considered possible, they must not drive and must notify the DVLA.
Licensing will be considered individually following medical enquiries.
What is the driving guidance you should give a patient with dementia?
Lorry/bus - cannot drive. All licenses revoked.
Car - may be able to drive but must notify the DVLA. A formal driving assessment may be necessary.
Considerations include:
- poor short-term memory, disorientation, and lack of insight and judgement almost certainly mean no fitness to drive
- disorders of attention cause impairment
- in early dementia, when sufficient skills are retained and progression is slow, a licence may be issued subject to annual review.
What is the driving guidance you should give a patient with PD?
May be able to drive but must notify the DVLA.
Licensing may be revoked if there is a danger at the wheel.
