Mental Health Follow Up After Attempted Suicide Policy
MHAS/8600
General Manager –
Approved by: Mental Health &
First Issued: April 2015
Addictions
Review Date: September 2021
Signature:
Next Review: September 2024
Purpose
To describe the appropriate follow up actions to be taken after significant suicide attempts.
This document is to be used in conjunction with MH&APPM/8953 –
Mental Health Service Policy which
outlines the shared vision and expectations for the direction, values, principles, attitudes and ways of working
to deliver a values based service.
Scope
This procedure applies to all Hawke’s Bay District Health Board (HBDHB) Mental Health Services (Adult,
EMHS, Addictions, Child Adolescent and Family (CAFS), Older Persons Mental Health (OPMH) and Springhill
Services) and partner Clinical Mental Health Services (Oranga Hinengaro o Te Matua a Maui and Te Poutama
Tautoko).
Definitions
Term/Abbreviation
Meaning
Significant suicide attempt
Either:
An attempt made where the person carrying out the act had a clear
intention to die, regardless of the method used, harm sustained or the
persons later regrets regarding their actions; or;
An attempt where significant harm has been sustained (inpatient medical
or surgical intervention required) regardless of the person’s intention to
die at the time of the act
Roles and Responsibilities
Role
Responsibility
Associate Clinical Nurse
Leads response in appropriate team and ensures appropriate registered
Manager/Manager (or
health professional(s) provides follow up.
equivalent)
Registered Health
Provides assessment and co-ordination of care to the person and
Professional
specialist treatment dependent on scope of practice
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HBDHB Procedure
1
Anyone who has been brought to the attention of Mental Health Services who has made a significant
suicide attempt should be assessed by a mental health registered health practitioner.
2
Further face to face should occur within 48 hours following initial assessment. This should be done via
Emergency Mental Health Service (EMHS), if out-of-hours, or by the person’s key worker during normal
working business hours, and follow up needs to continue until a safe discharge to GP can be managed
well or transfer to Community Mental Health (CMH) is made.
3
Clear and concise communication and assessment (where applicable) is essential, documented in ECA/
hard copy notes where applicable and relayed to persons General practitioner (GP).
4
All people who are assessed after a significant suicide attempt are identified within ECA as a suicide
attempt.
5
A collaboratively developed risk management plan must be completed with the person and relevant
others within five (5) working days of the initial assessment in the community.
6
Assertive efforts must be made to ensure follow up occurs.
7
The persons’ family/whanau, support network, LRT team and any other health care or social agencies
involved must be communicated with and involved as appropriate.
8
Where risk of suicide remains high the registered health professional is to submit name to the Mental
Health Services Local Response Team member for discussion at the next meeting (note meetings are
held fortnightly).
9
If the person declines follow up, despite assertive efforts, and the Mental Health (Compulsory
Assessment and Treatment) Act 1992 is not thought to apply, then an alternative means of monitoring
the persons progress must be made and documented (e.g. through keeping contact with a close family
member, reporting to General Practotioner (GP) as able).
Measurable Outcomes
Identification and audit of the care of all people relevant to this policy on a monthly basis will be undertaken
by the Clinical Nurse Manager (CNM) audit process.
Related Documents
MHAS/8046 -
Health Record Standards for the Mental Health Service
MHAS/8100 –
Mental Health & Addiction Services Admin Documentation Standards
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References
NICE quality standards [QS34]: Quality standard for self-harm. National Institute for Clinical Excellence, June
2013.
Serious Suicide Attempts: Systematic Review of Psychological Risk Factors. Yari Gvion* and imageYossi Levi-
Belz. Fronters in Psychiatry , published online 07 March 2018
Suicide Prevention and Follow-Up Services: A Narrative Review. Behrooz Ghanbari, Seyed Kazem Malakouti,
Marzieh Nojomi, Kaveh Alavi, and Shiva Khaleghparast. National Library of Medicine, National Institutes of
Health. Published online 2015 Sep 28.
A Review of Evidence-Based Follow-Up Care for Suicide Prevention: Where Do We Go From Here? Gregory
K. Brown, PhD, Kelly L. Green, PhD. American Journal of preventive medicine. Am J Prev Med
2014;47(3S2):S209–S215) & 2014 American Journal of Preventive Medicine
Patient perspectives on an intervention after suicide attempt: The need for patient centred and individualized
care. Michaud L, Dorogi Y, Gilbert S, Bourquin C (2021) PLoS ONE 16(2): e0247393.
https://doi.org/10.1371/journal.pone.0247393
Royal Australian and New Zealand College of Psychiatrists clinical practice guideline for the management of
deliberate self-harm. Gregory Carter, Andrew Page, Matthew Large, Sarah Hetrick, Allison Joy Milner, Nick
Bendit, Carla Walton, Brian Draper, Philip Hazell, Sarah Fortune, Jane Burns, George Patton, Mark Lawrence,
Lawrence Dadd, Michael Dudley, Jo Robinson, and Helen Christensen. First published in Australian and New
Zealand Journal of Psychiatry 2016, Vol. 50(10) 939-1000
Key Words
Mental Health
Suicide
For further information please contact the Clinical Manager – Emergency Mental Health Services
Hawke’s Bay District Health Board
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