Risk Management In Mental Health Services Page 42
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54Services should audit mental health facilities on a regular basis for
environmental suicide risks and take remedial action where possible. Non-
suicidal self harm accounts for a significant proportion (15.5%) of patient
safety incidents reported to the Clinical Indemnity Scheme from mental
health services during 2007.
As well as following the steps of clinical risk assessment outlined in
Chapter 3, the following parameters should be considered in assessing
suicidal risk (this is not an exhaustive list):
Components
Examples
History
a history of self-harm
a previous suicide attempt
a history of suicide in the family
trauma
sexual/physical victimisation
Clinical
a history of mental illness
a serious medical illness
alcohol abuse/elicit drug use
a history of self-harm
a history of low frustration tolerance
social or self alienation.
Personality
Cognitive Emotional Behavioural Skills Deficits.
Traits which are significant to cause individual or others
to suffer e.g. consistently impulsive or emotionally labile,
self-limiting and self-defeating beliefs and behaviours
Context/
Has the person experiences of any of the following:
Environment
- Recent loss by death or separation, a job, a pet
- A major life change or challenge (retirement,
redundancy, children leaving home, financial troubles).
As with violence and aggression prevention, it is easier to judge
the relative importance of the above signs if the mental health
team/professional already know the patient. Although risk cannot be
eliminated, it can be minimised by implementing good procedures for
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measuring and working with risk.
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