Immediate Management

1
Depression Anxiety

• Immediate Management

2
Psychiatric Assessment

• History
• Sleep, appetite, dysphoria, agitation, fatigue,
  anhedonia, concentration, esteem, suicide
• chronology
• Impact/functional status
• Alleviating/aggravating factors stressful life
  events, social/support networks, occupation
• Collateral information
• MSE

3
Suicide Risk

• Mental state/psychiatric disorders
• depressed, psychotic, despair, agitation,
  impulsivity (personality dx)
• Suicidal ideation/attempt
• nature, stressors (interpersonal crisis), intent,
  planned/impulsive, access to means, lethality,
  previous attempt(s), help sought after act?,
  suicide note?
• How do they feel now?
• Substance disorder
• ETOH and drugs
• Medical illness and FHx

4
Suicide Risk

• Older age
• Male
• Unemployed
• Low SES
• Decreased social support/Isolation

• Marital status
• Widowed, separated
• Adverse life events
• Death, trauma, anniversary
• Institutionalized
• army, prison

5
Management

• Physical safety
• Hospital admission?/referral to mental specialist
• Suicide risk, functional impairment
• Assess blood aspirin levels
• ?charcoal
• Patient education depression, lifestyle
  changes, treatments
• Psychological support
• Friends, family,therapists, GP, phone services
• Multidisciplinary team and mental health team