Suicide Risk and Self Harm

Question 1

Risk Factors of suicide - 6

Answer 1

• depression
• psychiatric disorders (90%)
• negative life events
• alcohol and drug misuse
• physical illness
• exposure to others suicidal behavior
• access to methods of self-harm

Question 2

How should a suicidal pt be assessed

Answer 2

• quiet room preferably on their own
• open questioning is more asvisable, although closed questions may be nessesary for clarification

Specific questions may include:
- are you feeling hopeless like life is not worth living
- have they made plans to end their life
- do they have access to sucicidal acts

Question 3

When should doctors involve others

Answer 3

With consent, its recommended that clinicians inform family and friends as a support network

if they cannot act with consent, clinician should act in the patients best interests

Question 4

Give examples of self harm methods - 7

Answer 4

• taking too many tablets
• cutting yourself
• burning yourself
• banging your head
• punching yourself
• sticking things into your body
• swallowing things that shouldnt be swallowed

Question 5

risk factors of self harm - 6

Answer 5

• young people
• being exposed to self-harm behaviour
• mental health problems
• childhood neglect or abuse
• stressful life events
• chronic physical health problems

Question 6

Complications of self harm -3

Answer 6

• acute liver failure (following paracetamol overdose)
• repeated self harm
• suicide risk

Question 7

Management following an act of self harm - 5

Answer 7

• examine physical injuries and treat
• assess mental state e.g. depression screen
• assess suicide risk
• assess safeguarding concerns especially with children
• ensure follow up is arranged

Question 8

Explain the Mental Capacity Acts 5 key principals

Answer 8

1. Presumption of capacity — adults should always be presumed to have the capacity to make a decision
2. Maximizing decision-making capacity — the person must be given all practical support before it can be decided that they lack capacity. Support may involve extra time for assessment, repeating the assessment if capacity fluctuates, or using an interpreter, sign language, or pictures.
3. The freedom to make seemingly unwise decisions — if the person makes a seemingly unwise decision, this in itself is not proof of incapacity.
4. Best interests — any decision or action taken on behalf of the person must be in their best interests.
5. The least restrictive alternative — when a decision is made on the person’s behalf, the healthcare professional must choose the alternative that interferes least with the person’s rights and freedoms while still achieving the necessary goal.

Question 9

What indicates that a person does not have capacity - 3

Answer 9

They are unable to:
- understand relevant infomation
- retain that infomation
- communicate their decision

Question 10

Who does the Mental Health Act allow compulsary admission of - 2

Answer 10

People who have a mental disorder that warrants treatment AND need to be admitted in the interests of their own or others health and safety

Question 11

Difference between Section 2, 3 and 4 of the Mental Health Act

Answer 11

2 - compulsary asmission for up to 28 days
3 - compulsary admission for up to 6 months
4 - compulsary admission for 72 hours in an emergency