Self harm and Suicide Flashcards
Define Self Harm
Intentional act of self poisoning/self injury
Usually as a form of emotional distress
Describe some potential methods of injury
Cutting, Burning, Hanging, Stabbing, Swallowing Objects
Describe some potential methods of poisoning
Medication, Illicit Drugs, Household Substances
Name 5 risk factors for Self Harm
Divorced Severe life stressors Harmful drug/alcohol use Chronic physical health problems Psychiatric Illness
What is the link between alcohol and suicide?
1/2 men and 1/4 women who self harm have taken alcohol in the last 6 hours
Describe some potential motives for Self Harm
Death Wish
Relief (eg being unconscious)
Influencing others (guilt tripping them)
Seeking Attention
Name two complications of Self Harm
Permanent scarring/damage to tendons and nerves
Acute Liver Failure
Name three investigations you could do in a patient that has self harmed
Bloods (Toxin levels, U and Es, LFTs, Clotting)
Urinalysis (Tox Screen)
CT Head
Name the antidote for Paracetamol
N Acetyl Cysteine
Name the antidote for Opiates
Naloxone
Name the antidote for Benzodiazepines
Flumazenil
Name the antidote for Warfarin
Vitamin K
Name the antidote for Beta Blockers
Glucagon
Name the antidote for Tricyclics Antidepressants
Sodium Bicarbonate
Name the antidote for Organophosphates
Atropine
What is the window in which you can give activated charcoal?
One hour
Describe the psychological management options for self harm patients
Counselling and CBT for depressive illness
Psychodynamic Psychotherapy for Personality Disorder
How soon after discharge should a self harm patient be followed up?
48hrs
Define Suicide
The fatal act of self harm with the intention of ending ones own life
Give 5 risk factors for Suicide
Mental Health Disorders Alone Male Ethanol Use Occupation (Vets, Doctors, Nurses, Farmers)
Give three protective factors against Suicide
Children at home
Religious Beliefs
Fear of the act
Name three ways someone who has attempted Suicide may present
Isolation/Withdrawal from society
Distraction and lack of pleasure
Hopeless and Helpless
Name some typical features of a Suicide History
Note left behind
Attempts to avoid discovery
Sorting out finances/changing will
Name the questionnaire used in attempted Suicide patients
Tool for assessment of Suicide Risk
Describe the 7 OSCE steps for suicide attempt history taking
1) Explore ideation (how do they feel?)
2) Explore Suicide Intent (Methods, Was it planned)
3) Exploring risk factors (PMH, FH)
4) MSE
5) Explore protective factors
6) Explore risk to others and risk from others
7) Formulate Management Plan
Name three reasons you would admit someone who has attempted Suicide to secondary care
Suicidal Ideation clearly stated
Lack of social support
Underlying psychiatric illness is severe
How would you manage someone with chronic suicidal thoughts but no action?
Outpatient and community treatment
Name three ways of preventing Suicide in the population
Public education and discussion
Reducing access to means of Suicide
Easy rapid access to psychiatric care
