Suicide & Self-harm

• What are the static RFs for suicide?

  Male

  FHx of suicide

  FHx of mental illness

  Adverse childhood experiences

  Age 18-25

  Over 65

  Alcoholism

  Hx of suicide attempts

  Bipolar/schizophrenia/borderline personality disorder/PTSD diagnosis

  Long term employed

  Rural setting

  Long term health conditions

  Stress from discrimination (LGBT, race, disability etc.)
• What are the dynamic RFs for suicide?

  • Recent life stressors (bereavement, divorce, job loss)
  • Financial stress
  • Poor coping skills
  • Recent Hx of substance abuse
  • Recent hospitalisation to mental health unit
  • Poor/loss of social support
  • Refugee status/asylum seeker
  • Impulsivity
  • Recent acute deterioration
  • Chronic conditions (pain)
  • Voicing suicidal thoughts
  • Making plans
  • Access to firearms
  • Putting plans in place (e.g. stockpiling medication)
• What are the protective factors for suicide?

  • Having children/family support
  • Having a religion
  • Good engagement with services
  • Employed
  • Good coping skills
  • Having a good social network
• What is self harm?

  Intentional self-injjury without a suicidal intent
• What is the cycle of self-harm?

  Emotional suffering

  Emotional overload

  Panic

  Self-harming

  Temporary relief

  Shame & guilt
• What is the treatment for an overdose of paracetamol?

  Acetylcysteine
• What is the treatment for an overdose of opioids?

  Naloxone
• What is the treatment for an overdose of benzodiazepines?

  Flumanzenil
• What is the treatment for an overdose of beta blockers?

  Glucagon (for HF & cardiogenic shock)

  Atropine (for symptomatic bradycardia)
• What is the treatment for an overdose of Ca+2 channel blockers?

  Calcium chloride or calcium gluconate
• What is the treatment for an overdose of cocaine?

  Diazepam
• What is the treatment for an overdose of cyanide?

  Dicobalt edetate
• What is the treatment for an overdose of carbon monoxide?

  100% oxygen
• What is the treatment for an overdose of methanol (solvents/fuels) or ethylene glycol (antifreeze)?

  Fomepizole or ethanol