Deliberate self-harm (DSH)/ attempted suicide

Question 1

History taking tips in suicide attempt:

Answer 1

Antecedent

• What has happened that has brought you here?
• When did the precipitating factor happen exactly?
• Did you post anything on social media before attempting this? Did you speak to anyone about how you were feeling? Did you communicate this to anyone else?

Event

• Where did you get the medication?
• How lethal did you think this would be?
• Did you research how much to take?
• What did you think would be the outcome of taking this?
• Do I need to be worried about your safety? Do your parents need to be worried about your safety?
• I can see that you are very distressed. Is there anything that you still wish you live for?

After:

• What happened after you took the overdose?

Question 2

What are the psychiatric red flags for risk of repetition of suicide?

Answer 2

Question 3

What are the different systems which must be considered as contributing to the condition? e.g. school

Answer 3

• All the factors in a person’s life which may be aggrevating or alleviating their condition.
• Individual - PMH, PPH, DH, Sx of drug use
• Family history - what is the family structure, PPH in family e.g. overdoses, DH in family, siblings, any protective factors like a supportive family member,
• Work/school - bullying, academic, support from teachers e.g. knowing, support, trust,; negative peers e.g. others engaging in self-harm (some kids may end up in groups who all self-harm), unrecognised autism/ADHD.
• Local community -

Answer 4