General Hospital Management of Suicide Attempters

© 2000 John Wiley & Sons, Ltd. All rights reserved. Most patients who receive treatment following deliberate self-harm first come to atten. :ion after presentation to a general hospital because of the effects of deliberate self-. poisoning or self-injury. This chapter describes the important aspects of the clinical care of these patients in the general hospital, including management in the accident and emergency department, medical care and psychiatric assessment, and attention to the risk of further suicidal behaviour in the general hospital. A structured assessment procedure is presented which incorporates attention not just to the problems that patients are facing, but also to the risk of further suicidal behaviour. The issue of multidisciplinary staffing of services for deliberate self-harm patients is addressed and a model for a service presented. Arrangements for aftercare are usually made by staff working in the general hospital, and while treatments are described in detail in other chapters some aspects are presented here, particularly in relation to the role of general hospital staff. General hospital provisions for very young and elderly attempters are discussed, as are aftercare possibilities for frequent repeaters of self-harm and substance abusers. Overall it is concluded that provision of good quality general hospital services for suicide attempters must be a key element in any local or national suicide prevention policy.