Self Harm

Question 1

An umbrella term for self-harm is any intentional self-poisoning or self-injury, irrespective of suicidal intent. Wha % of young people have self harmed before?

1 - 1.7%
2 - 7%
3 - 17%
4 - 47%

Answer 1

3 - 17%

Question 2

In paediatrics, what age does self-harm typically begin?

1 - 5-7 y/o
2 - 5-10 y/o
3 - 12-13 y/o
4 - 10-16 y/o

Answer 2

3 - 12-13 y/o

Peaks during mid-adolescence

Question 3

What of the following is NOT a static demographic risk factor?

1 - gender (Male)
2 - previous self harm
3 - (middle aged/elderly (>80)
4 - marital status
5 - social network (living alone)
6 - employment (unemployed)

Answer 3

2 - previous self harm

• employment is important because some jobs have means of suicide like dentists and farmers

Question 4

Risk factors can be static or dynamic. Which of the following is a dynamic factor?

1 - alcohol dependence
2 - death of parent at young age
3 - childhood abuse
4 - history of self harm

Answer 4

1 - alcohol dependence
- this develops over time
- these can be chronic or acute

Question 5

What of the following is NOT a static personal history risk factor?

1 - previous self-harm/suicide
2 - mental illness
3 - physical illness
4 - family history
5 - substance misuse/dependency
6 - personality disturbance
7 - history of loss or trauma
8 - employment (unemployed)

Answer 5

8 - employment (unemployed)

Question 6

When we assess risk, we must include all of the following:

• To self
• To others
• From others
• From self-neglect
• From physical health factors
• From behavioural factors

Question 7

When assessing the risk for a patient, does the risk assessment information come from just the patient?

Answer 7

• no
• Patients
• Parents / carers
• Teachers
• Employers
• Social services
• Other healthcare professionals

Question 8

When assessing the risk of an individual are we able to use the risk assessment from the first consultation with a patient?

Answer 8

• at that specific time yes
• BUT, risk is dynamic and will need repeating

Question 9

When we speak to a patient about self harm, we must include which of the following:

• Deliberate self-harm
• Methods used/Frequency
• suicidal thoughts
• suicidal intention
• suicidal plans
• suicidal methods tried/considered
• suicidal previous attempts
• all of the above

Answer 9

• all of the above

Question 10

Which of the following is the correct term to use if someone has taken their own life via suicide?

1 - parasuicide
2 - committed suicide
3 - successful suicide
4 - completed suicide

Answer 10

4 - completed suicide

Question 11

What is the lifetime risk of self harm?

1 - 1-2%
2 - 7-13%
3 - 25-40%
4 - >55%

Answer 11

2 - 7-13%
- accounts for 10% of medical admissions

Question 12

What is the average rate of completed suicides in the UK annually?

1 - >60
2 - >600
3 - >6000
4 - >60,000

Answer 12

3 - >6000
- specifically 6090
- 60% of successful suicides have a history or self harm

Question 13

Do men or women have a higher success rate of suicides?

Answer 13

• men (3-4x more likely)

Question 14

What % of completed suicides occur in an acute clinical setting?
1 - 49%
2 - 29%
3 - 2.9%
4 - 0.29%

Answer 14

2 - 29%

Question 15

When is the risk of suicide greatest following discharge?

1 - <12h
2 - <48h
3 - <72h
4 - <1 wk

Answer 15

3 - <72h
- now have the 72h follow up

Question 16

If a patient is at risk of self harm of suicide, is their mental or physical health the priority?

Answer 16

• physical health
• patient can be administered to hospital in some circumstances

Question 17

Which of following are effective psychological interventions for a patient at risk of self harm of ending their own lives?

1 - CBT
2 - coping strategies
3 - Dialectical behaviour therapy
4 - Emotionally unstable personality disorder therapy
5 - all of the above

Answer 17

5 - all of the above

• additional social support may include:
• problem solving techniques
• self care
• physical activity
• pleasurable activities – referral to community/charitable org e.g. MIND
• sleep hygiene