Citation

Sarkar J. Adv. Psychiatr. Treat. 2011; 17(6): 435-446.

Copyright

(Copyright © 2011, Royal College of Psychiatrists)

DOI

10.1192/apt.bp.110.008045

PMID

unavailable

Abstract

The challenge of managing repeated self-harm and the high risk of morbidity and mortality are compounded in forensic patients, where there are additional risks of harm to others, absconding and security breaches. There is an urgent need for clinically sound, practice-based and theoretically grounded strategies for managing these associated risks. This is essential as available UK guidelines appear inadequate for this group of patients. This article promotes a pragmatic approach to assessing the risk of self-harm clinically to arrive at hierarchical risk judgements. It further suggests an algorithmic approach to managing these risks and provides testable strategies that can be adapted for use in various secure institutions.

Language: en

Keywords

human; violence; drowning; alcoholism; lethality; prison; depression; schizophrenia; mortality; suicide attempt; suicidal behavior; risk assessment; hanging; comorbidity; disease severity; mood disorder; morbidity; review; substance abuse; personality disorder; self report; automutilation; self poisoning; bleeding; anxiety disorder; practice guideline; high risk behavior; risk management; onset age; high risk patient; adjustment disorder; tissue injury; predictor variable