suicide risk

Question 1

RFs for suicide

Answer 1

• past self-harm
• older age
• male sex
• psychiatric illness - substance misuse

Question 2

what factors say that this person is more likely to commit suicide again

Answer 2

• suicide note
• will
• alone when
• state wish to die
• belief that the act would be fatal
• lack of help seeking following the act
• sorrow or anger at failure and on-going suicidal intent are all indicators

Question 3

define self-harm

Answer 3

intentional act of self-poisoning or self-injury irrespective of the motivation or apparent purpose of the act. It is usually an expression of emotional distress.

Question 4

RFs for self harm

Answer 4

- Divorced/single/living alone
Severe life stressors
Harmful drug/alcohol use
Less than 35 (age)
Chronic physical health problems
Violence (domestic) or childhood maltreatment
Socioeconomic disadvantage
Psychiatric illness, e.g. depression, psychosis

Question 5

BSP Mx for self harm

Answer 5

􏰀 Biological: Includes treating any overdose with the appropriate antidote (see Key facts) and suturing (and anti-tetanus treatment if appropriate) for deep lacerations.
􏰀 Psychological: Includes counselling and CBT for underlying depressive illness. Psychodynamic psychotherapy may be appropriate if the individual has a personality disorder. However, this is a long term treatment and needs appropriate assessment.
􏰀 Social: Social services input and voluntary organizations (e.g. the Samaritans, Mind).

risk assessment is mandatory as there is an immediate risk of suicide and risk of repeat acts of self-harm. Need for hospitalization should be assessed ± use of the MHA Section 2.

crisis team

ensure that pt is followed up 48 hours