EM · Behavioural and mental health emergencies

Deliberate self-harm and suicide risk assessment

Also known as Deliberate self-harm · Self-harm presentation · Suicide attempt · Suicide risk assessment · Psychosocial assessment after self-harm · SAD PERSONS scale · Safety planning after self-harm

The patient who presents after deliberate self-harm — the sequence of medical clearance before psychosocial assessment, the structured suicide risk assessment (ideation, plan, intent, means, protective factors), the SAD PERSONS and Columbia tools, and the risk-stratified disposition (psychiatric admission for high risk, crisis team for moderate risk, GP follow-up with a safety plan for low risk). Covers the toxicological workup and antidotes (N-acetylcysteine for paracetamol, naloxone for opioid, sodium bicarbonate for tricyclic), the differential of accidental injury and intoxication, and the legal authority to detain. ACEM-primary, globally tagged.