09 Suicide Prevention and Self-Harm Care Free Online FlashCards

What does self-harm mean, and what should not be assumed?

Self-harm is intentional self-injury or self-poisoning. It may involve suicidal intent, no intent to die, or mixed or uncertain intent.

How should a clinician begin a conversation about self-harm?

Offer privacy when possible, use a calm and nonjudgmental tone, listen without blame or minimization, and thank the person for sharing.

What details should be asked about current thoughts of suicide or self-harm?

Ask plainly about suicidal or self-harm thoughts, how often they occur, and when they last occurred.

What should assessment cover about intent and a possible plan?

Ask whether the person intends to die, has considered a plan, can access what they might use, and has a timeframe or taken steps.

What should be explored about a person’s history of self-harm?

Ask about prior suicide attempts and self-injury, including the person’s intent and what happened afterward.

What can—and can’t—a suicide screening score establish?

Screening tools can identify a need for follow-up, but cannot reliably predict an individual’s future behavior or determine discharge by themselves.

Do protective factors cancel urgent suicide-risk concerns?

Protective factors can support a care plan, but do not cancel current intent, a feasible plan, access to lethal means, or other urgent concerns.

What should happen if someone cannot be kept safe in the current setting?

Stay with the person, promptly alert the responsible clinician, and arrange urgent emergency or specialist evaluation under local policy. Do not let them leave alone before safety is assessed.

How can care teams help reduce access to lethal means?

Work collaboratively to reduce access to lethal means, such as discussing safer medication storage or temporary off-site firearm storage where lawful and feasible.

What should a collaborative safety plan include?

Include warning signs, independent coping strategies, sources of distraction or connection, trusted contacts, clinical or emergency options, and steps to make the environment safer.

Why is a safety plan not a “contract for safety”?

A safety plan is not a contract or promise not to self-harm. Such promises do not replace assessment, observation, treatment, or follow-up.

When is initial aftercare recommended after self-harm if safety concerns continue?

After self-harm, NICE recommends initial aftercare within 48 hours of psychosocial assessment when safety concerns continue.