Rationale

Suicidal behaviour is a common psychiatric emergency and a major cause of death across age groups. It causes major distress to surviving relatives and others.

Causal Conditions

(list not exhaustive)

1. Psychiatric disorder (e.g., depression, schizophrenia)

2. Psychosocial stressors (e.g., divorce, adverse childhood experience)

3. Substance use

4. Other (e.g., serious chronic disease)

Key Objectives

Given a patient with suicidal behaviour, the candidate will determine the degree of risk and institute appropriate management.

Enabling Objectives

Given a patient with suicidal behaviour, the candidate will

1. list and interpret critical clinical findings, including

   1. potential contributing conditions identified through an appropriate history and physical examination;

   2. assessed and quantified risk for suicide, including imminent risk, recent stresses and life events;

2. list and interpret critical investigations, including

   1. illicit drug and alcohol screen, where appropriate;

3. construct an effective initial management plan, including

   1. ensuring the safety of patient at imminent risk for self harm (e.g., urgent hospitalization), including continuous observation while arrangements are being made;

   2. assessing capacity to make decisions if patient demands to leave;

   3. initiating management of underlying problems if the risk for suicide is not imminent (e.g., depression, psycho-social stressor);

   4. maintaining confidentiality while recognizing the benefits of support networks (e.g. family, culturally specific interventions);

   5. referring the patient for specialized care, if necessary.