Suicidality and self-harm behaviours? - Ideations? ---- None or abstract? - Expresses preference to die or to self-harm or shows intent? - Means - Plan? ---- No firm plan? ---- Immediate concrete plan? - History of self-harm? Violent and aggressive behaviours? - Significant recent history of abusive behaviour or violence? Previous mental health history? - No history of mental problems? - Previous history of mental health problems? - Affective disorder? - Schizophrenia? - Personality disorder? - 1st symptoms later in life? - Family history? History of alcohol or drug misuse? Social history? - Marital status? - Living? - Employment? Protective factors? - Family support? - Strong religious faith? - Having children at home? - A sense of responsibility? - Problem solving skills? Safeguarding concerns? - Known dependents? - Safeguarding risks? - As victim? - Towards others? Other Past medical history? Current medication? Drug allergies? Management: Low risk (minor mental health problems)? Discussed treatment for MH problems (eg talking therapy +/- medication) Advised to contact own GP Intermediate risk (at risk of suicide but has protective factors, may have suicide plan)? Asked if friends/family could help Contact details for Samaritans given Referral to mental health team if support unavailable Next appointment planned High risk (well thought out suicide plan, can't see point in treatment as 'nothing will change')? Referred to mental health service urgently Considered whether it would be unsafe for patient to be left in building alone Reference(s): BMJ: Thoughts of suicide - initial assessment Geeky Medics: Suicide Risk Assessment - OSCE Guide