Risk Assessment Following Episode of Self Harm

Question 1

Questions you want to ask about the self harm event

Answer 1

Method of self harm
-what, how much, timescale

Alcohol/illicit drugs involved

Where they alone, hiding from others

Spontaneous or planned

Intent to die?

Final plans made?

Did they seek help afterwards
Stressors?

Question 2

Background history

Answer 2

Past suicide attempts/self harm?
Psych history
Current and past diagnoses/treatment
-engagement/compliance?
Medical history
-any ongoing problems with pain
-chronic/terminal illness/disability?
-MUS?
-learning difficulties

Question 3

Social history

Answer 3

Recent loss
Relationships - supportive/difficult?
Childcare responsibilities
Family and social support?
Accommodation, employment and finances
ADLs and level of functioning
Drug and alcohol use

Question 4

What are the risks to others?

Answer 4

Children and responsibility as a carer?
Work responsibilities?
Past violent acts/arson?
Suicide pacts/involvements of others in self harm attempts?

Question 5

What are the risk factors for suicide?

Answer 5

Male
Increased age

Hopeless
Impulsive/aggressive tendencies

Chronic mental illness
Physical illness

Past self harm/suicide attempts
Access to lethal means
Substance misuse
Trauma/abuse

Media/social influence
Social isolation

Question 6

Assessing risk to others

• past history
• substance misuse
• current mental state/psych illness

Answer 6

Past convictions, prison sentences?
Past acts and thoughts of violence/cruelty to others/animals/property
Impact of past psych history on behaviour in past

Current and past drug, alcohol use

• were they under the influence?
• do they drive under the influence

Psychotic features
-command hallucinations
-persecutory delusions
-delusions of jealousy
Low mood, mania clouding judgement and reckless behaviour
Cognitive impairment?
Personality traits (callous, impulsive?)

Any intent to commit acts of violence or crime?
Potential victims
When could this act occur and how?