alys cole-king improving mental health crisis care
TRANSCRIPT
Improving Mental Health Crisis Care
Suicide Mitigation early intervention and averting crisis
Dr Alys Cole-King MB, BCh, DGM, MSc, FRCPsychRoyal College of Psychiatrists Spokesperson on Suicide and Self harm
Consultant Liaison Psychiatrist BCU HBClinical Director Connecting with People
@AlysColeKing
Objectives
• Combining compassion and clinical governance
• Risk management or risk mitigation?
• Safe and effective triage, referral and response to people at risk of suicide
• Safety Plans
•Mortality elevated post self-harm – especially first year¾ Suicide - self-poisoning/other methods¾ Accident – incl by poisoning¾ Alcohol or drug related¾ Respiratory disease and lung cancer.
•Alcohol misuse or dependence strongest predictor mortality
Self-harm in Primary Care Patients
Take people who present with self-harm seriously. It is an opportunity to intervene and potentially save their life
• Huge primary care data set
• People who attend primary care following S-H have an increased mortality rate highest within first year
• People who attend primary care following S-H repeat
• 1 in 5 repeat within a year
Key Findings Self-harm in Primary Care Patients
Classification of suicidal thoughts (Cole-King 2010)
Passive Active Dangerous Dangerous &Imminent
Characteristics
Nature of thoughts
Perception of future
Planning
Preparation
Ability to resist
Safe triage & response required
Self-help leaflets
U Can CopeFeeling overwhelmed
and staying safe
Feeling on the edge helpingyou get through it
www.connectingwithpeople.org/
Safety plan
• Reasons for living • Safe environment
¾ Identify distress triggers ¾ removing ways to harm yourself
• Activities to calm/lift mood or distract• Contacts for general support• Specific suicide prevention support• Professional support • Emergency contact details• Personal commitment to follow safety plan
Staying safe if you’re not sure life’s worth living- to share hope, compassionate advice, practical ideas & links for people in distress http://www.connectingwithpeople.org/StayingSafe
U Can Cope 22m film and online resources - for people in distress and those trying to support them to share hope, useful strategies and national organisations for support http://www.connectingwithpeople.org/ucancope
RCGP free suicide prevention e-learninghttp://www.rcgp.org.uk/learning/online-learning/ole/suicide-prevention.aspx
References:• Cole-King A, Green G, Gask L, Platt S (2013) Suicide Prevention are we doing enough?
Advances in Psychiatric Treatment. 19:284-291
• Cole-King A, Garett V, Williams H, Hines K, Platt S (2013) Suicide mitigation embedding compassion in clinical care. Advances in Psychiatric Treatment. 19:276-283
• Hines K, Cole-King A (2013) ‘Hey Kid are you OK..a story of a suicide attempt’ Advances in Psychiatric Treatment. 19:292-294
• Cole-King A, Lepping, P Suicide mitigation: time for a more realistic approach. 2010. BJGP 3-4• Cole-King A, Lepping P (2010) Personal view: Will the new Government change our approach
to risk? British Medical Journal, July. 341: c3890.• Cole-King A, Green G, Peake-Jones G, Gask L (2011) The Assessment and Management of
Patients with Suicidal Thoughts in Primary Care: An introduction to the concept and practicalities of suicide mitigation. Innovaite Vol 4: issue 5, 288-295
• Cole-King A, Green G, Wadman S, Peake-Jones G, Gask L (2011)Therapeutic assessment of patients following self harm in primary care. Innovaite Vol 4: issue 5, p278 -287
• Cole-King A (2010) Suicide Awareness in Primary Care: How making the right connections can save lives. RCGP News p 6.
• 2009 4 RCPsych peer reviewed poster presentations of all clinical tools