Makindo Medical Notes.com

In hospital all overdose patients get or should get a psychiatric evaluation. In General practice, depressed patients are commonly found and the doctor should have a good idea who is at risk of self-harm. Some common features help identify individuals at greater risk. Check your local policy but anyone with a suicide attempt should have a psychiatric evaluation before discharge. Patients may even try to self-discharge. Get help from psychiatry and take senior advice.

Signs increasing the risk of Suicide

• Males, Aged > 40, Lives alone, Recent bereavement
• Alcohol abuse, Financial/business/work problems
• Having a suicide attempt involving a lethal/violence method
• Took precautions to prevent being found or disturbed
• Found afterwards rather than self-presentation
• Puerperal, Single - unmarried /divorced
• Chronic painful illness, Still expressing a wish to die
• Most people who commit suicide have seen a doctor in the preceding month

Management

• Check your local policy but anyone with a suicide attempt should have a psychiatric evaluation before discharge.
• Patients may even try to self-discharge. Get immediate help from psychiatry and take senior advice.
• If a patient admitted with suicidal ideation or overdose tries to leave then immediately involve psychiatry, family if appropriate and police.
• It is not unknown for patients to abscond from a CCU following an overdose and commit suicide.