Suicide and Self Harm Mitigation
A strategic approach to suicide and self harm
reduction in primary care
Cheshire & Merseyside Suicide Reduction Summit 4th
February 2015
Alys Cole-King, MB, BCh, DGM, MSc, FRCPsych
@AlysColeKing
Mental
illness 1 in 3
Suicidal
thoughts
1 in 5
5
5
Identification of suicide risk
Patients identified as high
risk
Surface Level
Patients identified as low
risk
Strategic priorities in suicide prevention
Clinical
GOVERNANCE
Practitioners
have the right
SKILLS
The people
they approach
show
COMPASSION
Suicidal
People are
AWARE they
need help
Key elements of suicide prevention
Compassion
Eradicate
Stigma
Awareness
Knowledge
Skills
Common
launguage
Minimise
Human
Factors
Errors
Self-care
Resilience
& help
seeking
Suicide
Prevention
Changing working practices
in primary care
Compassion
Reduce
Stigma
Bite Sized
Training
Consistent
Assessment
Framework/
Language
Self Help
Resources
Wellbeing
&
Resilience
Safety Plans
Enhancing response primary care
Awareness,
Knowledge &
skills in
Assessing &
recording
Safely &
efficiently
triage
Co-create
safety plan
Removal
means
Third sector
Safely &
efficiently
refer to
specialist
services
Clinical
governance
Common
language
Suicide Prevention Training Programmes
Specialist MH Services
Emergency Department
GP with special interest
General Hospital staff
Rural primary care services
Secondary
Care
Primary Care & Third
Sector Healthcare
Services
Non-clinical NHS and Social Care
Staff, Frontline staff, General Public
GP & primary care
teams
Counselling
services
Allied health Profs
Pharmacy
Solutions
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Engage with GPs to increase training uptake
RCGP Curriculum
CPD sessions
RCGP Mental Health Training Advisory Group
Equal status given to suicide prevention training as CPR
Needs to contribute to reduced HFE
Needs to contribute to robust clinical governance
Appraisal & revalidation
• RCGP signed up to the Crisis Concordat
Self-help leaflets
U Can Cope
Feeling on the edge helping
you get through it
Feeling overwhelmed
and staying safe
www.connectingwithpeople.org/
References:
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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. 19:276283
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
Classification of suicidal thoughts (Cole-King 2010)
• Passive
• Active
• Dangerous
• Dangerous
and
imminent