Self harm risk scenario
candidate brief
25yo Ash attended ED with wounds to thigh
wounds have been managed, patient is keen to go home
please perform a risk assessment of the patient
actor brief
Ash, DOB 01/01/2001
pocket knife - superficial wounds - now dressed
after argument with girlfriend - overwhelmed by emotion
no suicidal ideation
previous self harm - usually similar, with pencil sharpeners or pocket knives
now regrets doing it, feels a bit silly, and is feeling calmer - doesn't want to wait to be seen by MHLT
has network of friends who are aware of their self harm in the past + good GP
will agree to outpatient referral
examiner brief
- Washes hands, introduce self
- Confirm patient identity
- Consent to conversation
- Ensures private space to have conversation
- Asks about injury and how sustained
- Ensures wounds treated appropriately
- Asks about triggers
- Explore reasons for wanting to leave
- Asks appropriate questions to assess risk
- intent with this episode of self harm
- previous self harm
- excess drugs/alcohol
- relationships
- social support
- patient's future attempt (states that will try again)
- current suicidal ideation
- establishes if attempt was
- planned or impulsive
- life-threatening
- Appropriate use of silence to allow patient to speak
- Invites questions
- Agrees management plan with patient
- Global mark from examiner