General management and advice to patient and family

(ref 211)

• Assessment of suicidal ideation is an important part of the mental state examination of anyone who presents with a mental health problem.
• Any underlying mental disorder needs to be treated.
• Patients who, as a result of assessment, are considered at risk of further self-harm should be reviewed regularly by the GP.
• Psychological treatments may help the person make sense of their difficulties without feeling the need to self-harm (ref 212). The approach that therapists usually use involves paying attention to how a person is feeling rather than concentrating directly on whether or not they are harming themselves.
• Clinicians managing complex or protracted cases of self-harm should consider seeking peer support or supervision.
  

References

211 NICE will publish a guideline on the management of self-harm in March 2004.

212 Hawton K, Townsend E, Arensman E et al. Psychosocial and pharmacological treatments for deliberate self-harm (Cochrane Review). In: The Cochrane Library, Issue 2, 2003. Oxford: Update Software. (AI) Twenty-three studies were analysed. Promising results were found for problem-solving therapy, provision of a card to allow emergency contact with services, depot flupenthixol for recurrent repeaters of self-harm and long-term psychological therapy for female patients with borderline personality disorder and recurrent self-harm.

Last edited: 4/2/2004

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