Suicide and Self Harm

Question 1

Definition

Answer 1

• Self harm is the act of harming yourself as a means of dealing with difficult feelings = viewed as a coping mechanism for underlying emotional or psychological distress.
• May be performed with suicidal intent or not. Individuals may experience a short sense of release after self harming, however individuals can become dependent on the acts.

Question 2

Epidemiology + Risk factors

Answer 2

• Age: more prevalent in adolescents and young adults
• Past history of trauma or abuse
• Co-existing mental health conditions
• Access to controlled drugs
• Economic instability

Question 3

Signs

Answer 3

Examples of self harm include:
- Cutting own skin with a sharp object, e.g. razor blade or pencil
- Hitting or punching self, or hitting self against a wall
- Burning own skin, e.g. with a lighter or candle
- Applying tight ligatures to own skin

Question 4

Diagnosis

Answer 4

• Psychiatric assessment:
  To assess the mental state and risk of further self-harm or suicide
  Activities associated with completing suicide include:
  Leaving a suicide note or changing a will
  Purchasing a gun, rope or medications
  Putting finances in order
  Wound culture: if signs of infection are present, if self-harm involves damage to skin

Question 5

Management

Answer 5

• CBT
• Antidepressants: SSRI fluoxetine
• Wound care
• Crisis helpline
• Applying a Mental Health Act section

Question 6

Complications

Answer 6

• Wound infection
• Permanent scarring or disfigurement
• Progression to suicidal behavior
• Emotional deterioration: if not adequately managed