Suicide And Self-Harm Flashcards
What is the epidemiology of self-harm and suicide?
Greater incidence in females 16-24 years old
Men between 25-34 years old
Majority are below the age of 35 years old
Divorced and single relationship status
Unemployment
Precipitating factors are alcohol intake and argument with a partner
Life events
Gay and bisexual sexual orientation
What is the assessment for suicide?
Method performed and planning for the method
-> Degree of planning and timing
->Preparatory acts
->Expectations of act
->Feelings following act
->Intention to repeat act
->History of self-harm
->Past psychiatric history
->Screening for social stressors
->Screening for mental illness and substance use
->Mental state examination
What is the assessment for self-harm?
Psychosocial assessment at the earliest opportunity after self-harm episode within 48 hours in primary care
Explore the personal desire for self harm
Treat each episode of self-harm individually
Explore patient factors contributing to self-harm
What are the considerations for assessing self-harm in young people?
Social group
Caring responsibilities
Use of social media and internet and effects of these on mental wellbeing
Safeguarding issues
What are the considerations for assessing self-harm in the elderly?
-> Assess the risks of depression, cognitive impairment, physical ill health and frailty
-> Increased potential for isolation
-> Risk of higher suicide rate following self-harm for older people
Which mental health act is used to detain patients for a suicide attempt?
Section 5.2, which gives doctors the powers to detain inpatients for 72 hours to make an ASSESSMENT for mental disorder and risk of further harm if the patient is unwilling to remain informally.
This does not authorise treatment.
What are the risk factors for non-fatal self-harm?
Depression
16-24 year old females and 25-34 year old men
Low socioeconomic group
Social isolation
Bereavement by suicide
Mental health co-morbidity
Chronic physical health issues
Forensic history
What are the risk factors for completed suicide?
45-64 year old male
Living alone
Previous-self harm episode
Diagnosed mental health condition and current psychiatric treatment
What is effective communication for individuals who have self-harmed?
Open questions and non-judgemental
Direct questions about attempt
Using appropriate language and pauses
Avoid assumptions
Empathetic and hopeful for the patient
What are the consequences of self-harm?
Acute liver failure following paracetamol overdose
Permanent scarring of the skin and tendon damage from self-cutting
Elevated suicide risk
What is the long-term management for self-harm?
Harm minimisation techniques
Creating a care and crisis plan
Referral to community mental health team/CAHMS
Reinforce coping strategies
