A 19-year-old attends the emergency department after taking an overdose of paracetamol following a row with a partner. She is medically fit. What should happen before discharge?
Answer and explanation
Correct answer: A. A psychosocial assessment by a trained mental health professional
- Step 1: NICE NG225 requires a psychosocial assessment after self-harm.
- Step 2: Risk scales should not be used to predict suicide or decide who is discharged.
Answer
A psychosocial assessment by a trained mental health professional.
Why not the others: Discharge with no assessment: Impulsive acts still carry risk. A signed contract in which she promises not to self-harm again after discharge: No-suicide contracts have no evidence of benefit. A risk scoring tool alone to decide whether she can safely be discharged: NICE advises against using risk tools to predict.
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