Risk - suicide/self harm Flashcards
what are risk factors for suicide?
increased mental illness bipolar disorder depression borderline personality disorder anorexia substance abuse past self harm suicide attempts
what are the three rings of suicide assessment ?
the inner ring
the middle ring
the outer ring
what is the inner ring assessment ?
what happened that day were things normal to start with when did the feelings and events leading up to the act start ? get descriptions of these in detail was there any last act (suicide letter) what happened after the act who called for help how do they feel about it now (embarrassed, guilty, regretful)
what is the middle ring assessment ?
how things have been over the preceding months
might the attempt have been made at any time over the last months
what relationships were important over this time
hoarding tablets ?
what is the outer ring assessment ?
relevant FHx and personal Hx
what are the 4 stages of management for suicidal patients ?
agree a contract offering help, talk with support network (family friends) as to tackle problems are to be tackled
treat any co morbid conditions (depression, anxiety, substance misuse)
problem solving therapy helps by pointing out how the patient coped with past problems
follow up with preventive strategies
- promote access to samaritans and doctors
- limit access to lethal methods
- social support if needed
in what situations would someone need urgent assessment ?
severe behavioural disturbance
- organic (delirium, brain injury, intellectual disability)
- intoxication
- psychiatry (psychosis, anxiety, mania)
- personality (anti social)
self harming behaviour
neuroleptic malignant syndrome
what symptoms does neuroleptic malignant syndrome have?
anti-psychotic induced disorder
fever, muscle rigidity, delirium, autonomic instability
marked raised CK
