Suicide/Self-Harm Flashcards
What is the definition of suicide?
Any act that deliberately brings about one’s own death
What is the definition of self-harm?
Any act intentionally causing physical injury to the body, but not resulting in death.
NOTE: • It is important to distinguish between self-harm and attempted suicide
Give some social causes of suicide
• Life Events and Stress
E.g bereavement and childhood adversity
• Social Class
Social classes I and V are at highest risk of suicide
Social Isolation
More common if isolated, divorced, widowed, single, unemployed or living alone
• Occupation
Higher rates in vets, pharmacists, dentists, farmers and doctors
Likely to be due to increased access to lethal means (e.g. drugs/firearms)
Give some mental health causes of suicide
• Previous suicide attempt • Previous self-harm • Depression • Substance Misuse • Personality Disorders • Other factors Physical health problems (chronic, painful and terminal illness) Family history
Give one charity that provides support for families of suicide victims
SOBS: Survivors of bereavement by suicide
Give some common reasons for self-harm
o Avoiding more dangerous self-harm or suicide
o Self-punishment
o Suicide attempt
o Substituting psychological distress with physical pain
o Overcoming numbness
Give 5 domains of management for a patient with self-harm
Physical treatment Risk assessment ?Immediate intervention Follow-up intervention Coping strategies: to decrease or avoid self-harming
What are some potential physical treatments for self-harm
Overdoses: Activated charcoal (decreases intestinal absorption of substances, e.g antidepressants) Antidotes (e.g N-acetylcysteine for paracetamol OD)
Treating physical injury
Sutures, plastic surgery, analgesia
What needs to be considered in a risk assessment?
What is the immediate risk of suicide/harm for this patient?
What is the future risk of suicide/harm for this patient?
(Including potential harm to others)
Pts capacity needs to be assessed
Give examples of some features that increase the risk of future suicide attempt?
- Careful planning
- Final acts in anticipation of death (e.g. writing wills)
- Isolation at the time of the act
- Precautions taken to prevent discovery (e.g. locking doors)
- Writing a suicide note
- Definite intent to die
- Believing the method to be lethal (even if it wasn’t)
- Violent method (e.g. shooting, hanging, jumping in front of a train)
- Ongoing wish to die/regret that the attempt failed
What are some potential immediate interventions and when would they apply?
• If at high risk of suicide and lacking capacity, they need to be admitted to a psychiatric ward for their own safety
Make a plan to deal with future suicidal ideations:
- Who will the patient tell?
- How will they get help? - who to call, where to come
What follow up interventions need to be put in place?
• Follow-up within 1 week of the self-harm or discharge from the inpatient ward This could be: • Community mental health team • Outpatient clinic • GP • Counsellor
What potential coping strategies to decrease risk of self harming can be put in place?
- Put tablets and sharp objects away
- Avoid self-harm triggering images (e.g. photos online)
- Stay in public places or with supportive people when tempted to self-harm
- Call a friend or support line
- Avoid drugs and alcohol
- Squeeze ice cubes
- Snap a rubber band around their wrist
- Bite into something strongly flavoured (e.g. lemon)
Give an example of a biopsychosocial approach to treat a patient who has been followed up following an attempted suicide
Biological: treat underlying mental health cause if present (e.g antidepressants)
Psychological: counselling, CBT
Social:
Engagement in mood raising activities (e.g walking, exercise, reading)
Social support: meeting up with friends, activities with family
Targets: propose targets for patient (e.g try and arrange to meet up with a friend for coffee within the next week)
