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Psychiatry / Alcohol and Drug

Psychiatry / Alcohol and Drug. FELLOWSHIP SAQ PRINCIPLES. Suicide risk assessment. SAD PERSONS Sex – male 1 Age - >55yr or youth 1 Depression (PMH) 2 Previous attempt 1 Ethanol / drugs 1 Rational thought loss 2 Separated / divorced / widowed 1

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Psychiatry / Alcohol and Drug

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  1. Psychiatry / Alcohol and Drug FELLOWSHIP SAQ PRINCIPLES

  2. Suicide risk assessment • SAD PERSONS • Sex – male 1 • Age - >55yr or youth 1 • Depression (PMH) 2 • Previous attempt 1 • Ethanol / drugs 1 • Rational thought loss 2 • Separated / divorced / widowed 1 • Organised plan / serious attempt 2 • No supports 1 • Sickness (organic) 2 • <6 low, 7-8 moderate, >8 high risk

  3. Risk stratification of suicideattempt • IPMO • Intent • Plan • Motivation • Opportunity • Risk:Resue ratio • Lethality vs publicity

  4. Depressive Illness • IN SAD CAGES • Interest • Sleep • Appetite • Depressed mood • Concentration • Activity • Guilt • Energy • Suicidal ideation • Major depression >=5/9 for >=2 weeks

  5. Violent Patient • Safety • Self, staff, other patients, violent patient • Strategies approach • Recognition - PHx, current Hx, drugs and EtOH • prevent escalation – see early, show force, set limits, up triage, area • Restraint • Verbal, show of force, physical 6 pt arrow, chemical PO IM IV • Safe disposition • Inpatient, outpatient • Continued quality improvement • CISD • Future prevention violence – ED design, control access, education, undress all patients • EXCLUDE ORGANIC CAUSE!!

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