Suicide Flashcards
Self harm definition
A self-poisoning or self-injuring intentional act to express emotional distress. Includes suicide attempts.
Risk factors for self harm
Socio-economic disadvantage, socially isolated (divorced, single parents, asylum seeker, sexual minority), mental health problems, chronic physical health condition, alcohol and drug abuse, childhood maltreatment, domestic violence, involvement with the criminal justice system.
Suicide risk in self harm patients
The risk fo suicide is significantly increased in people who self-harm (between 50 and 100 times more).
Assessing suicide risk
Does the patient have risk factors for self harm?
How major is their suicidal intent?
Mental state examination
Current social support of that patient and the actual psychosocial needs of the patient.
Any protective factors which might reduce the risk.
Safeguarding concerns.
Management of a patient presenting at risk of self-harm
Assess capacity of patient. Refer to crisis team/community health team. remove access to means of self-harm (prescription drugs given in small quantities at a time). Offer information to carers and relatives.
Management of patient presenting with self-harm
Admit to A&E if significant risk of physical or psychological harm otherwise treat in primary care.
If self-poisoning = consult TOXBASE or specialist advice.
Assess capacity of patient.
Arrange follow up appointment.
Assessing suicidal intent
Was it planned in advance or impulsive act? (Did they make a will or note. Planning indicates was an act of finality).
Were precautions taken to avoid discovery or rescue?
Was help sought after the act/immediate regret?
Examples of risk to self behaviours
self harm, self neglect, suicide, exploration (sexual e.g. prostituion, financial, social e.g. use home), impair judgement (driving risk), substance misuse, non-compliance to meds leading to relapse.
