Suicide Mitigation early intervention and averting crisis

Transcription

1 Improving Mental Health Crisis Care Suicide Mitigation early intervention and averting crisis Dr Alys Cole-King MB, BCh, DGM, MSc, FRCPsych Royal College of Psychiatrists Spokesperson on Suicide and Self harm Consultant Liaison Psychiatrist BCU HB Clinical Director Connecting with

2 Objectives Combining compassion and clinical governance Risk management or risk mitigation? Safe and effective triage, referral and response to people at risk of suicide Safety Plans

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7 Self-harm in Primary Care Patients Mortality elevated post self-harm especially first year Suicide - self-poisoning/other methods Accident incl by poisoning Alcohol or drug related Respiratory disease and lung cancer. Alcohol misuse or dependence strongest predictor mortality

8 Key Findings Self-harm in Primary Care Patients Take people who present with self-harm seriously. It is an opportunity to intervene and potentially save their life Huge primary care data set People who attend primary care following S-H have an increased mortality rate highest within first year People who attend primary care following S-H repeat 1 in 5 repeat within a year

9 Identification of suicide risk Patients identified as high risk Patients identified as low risk

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11 Strategic aspects suicide prevention

12 Strategic suicide prevention

13 Classification of suicidal thoughts (Cole-King 2010)

14 Classification of suicidal thoughts (Cole-King 2010) Passive Active Dangerous Dangerous & Imminent Characteristics Nature of thoughts Perception of future Planning Preparation Ability to resist Safe triage & response required

15 Self-help leaflets U Can Cope Feeling overwhelmed and staying safe Feeling on the edge helping you get through it

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17 Safety plan Reasons for living Safe environment Identify distress triggers removing ways to harm yourself Activities to calm/lift mood or distract Contacts for general support Specific suicide prevention support Professional support Emergency contact details Personal commitment to follow safety plan

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19 Staying safe if you re not sure life s worth living- to share hope, compassionate advice, practical ideas & links for people in distress U Can Cope 22m film and online resources - for people in distress and those trying to support them to share hope, useful strategies and national organisations for support RCGP free suicide prevention e-learning

20 References: Cole-King A, Green G, Gask L, Platt S (2013) Suicide Prevention are we doing enough? Advances in Psychiatric Treatment. 19: Cole-King A, Garett V, Williams H, Hines K, Platt S (2013) Suicide mitigation embedding compassion in clinical care. Advances in Psychiatric Treatment. 19: Hines K, Cole-King A (2013) Hey Kid are you OK..a story of a suicide attempt Advances in Psychiatric Treatment. 19: Cole-King A, Lepping, P Suicide mitigation: time for a more realistic approach BJGP 3-4 Cole-King A, Lepping P (2010) Personal view: Will the new Government change our approach to risk? British Medical Journal, July. 341: c3890. Cole-King A, Green G, Peake-Jones G, Gask L (2011) The Assessment and Management of Patients with Suicidal Thoughts in Primary Care: An introduction to the concept and practicalities of suicide mitigation. Innovaite Vol 4: issue 5, Cole-King A, Green G, Wadman S, Peake-Jones G, Gask L (2011)Therapeutic assessment of patients following self harm in primary care. Innovaite Vol 4: issue 5, p Cole-King A (2010) Suicide Awareness in Primary Care: How making the right connections can save lives. RCGP News p RCPsych peer reviewed poster presentations of all clinical tools