🧠 PsychiatryMental health / EmergencyStudentInternResident

Deliberate Self-Harm & Suicide-Risk Assessment

Also known as: self-harm · suicide risk · deliberate self-poisoning

Any act of intentional self-injury or self-poisoning, with or without suicidal intent — a common emergency and a key opportunity to treat the physical consequences, assess risk, and offer help.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

All ages; higher risk with mental illness (depression, substance use), previous self-harm, chronic illness/pain, social adversity and impulsivity.

Red flags — escalate / refer

Ongoing suicidal intent or a plan, a violent/high-lethality method, expressed hopelessness, refusal of help, or dangerous physical effects → do NOT leave the person alone; ensure a safe environment and urgent psychiatric input.

Work-up / diagnosis

1FIRST treat the physical injury/poisoning (e.g., a paracetamol level and the antidote pathway).
2Then a compassionate biopsychosocial risk assessment — intent, planning, lethality, precipitants, protective factors, mental illness and support; assess capacity.

Management — overview

Treat the medical consequences and keep the person safe (remove means, provide supervision); manage pain/agitation humanely.
Arrange a specialist psychosocial assessment for everyone who self-harms; treat any underlying mental illness.
Make a safety plan, involve family/carers appropriately, and arrange follow-up; a non-judgemental approach improves engagement.

In-depthFull dosing & advanced protocol

Drug dosing

Treat the specific poisoning / underlying illness

No drug treats the act itself

Adult dose: e.g., N-acetylcysteine for paracetamol; treat mental illness per protocol
Route: Per cause

WHOWHO mhGAP Intervention Guide (mental health in non-specialist settings) ↗

Treat the body and the mind

Never discharge without a psychosocial assessment.
Asking about suicide does NOT increase risk; restricting access to means saves lives.
Repeated self-harm carries a real long-term suicide risk — follow up and support.

WHOWHO mhGAP Intervention Guide (mental health in non-specialist settings) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

DepressionA common mental disorder — persistent low mood and/or loss of interest for ≥2 weeks with cognitive and physical symptoms and functional impairment. It is very treatable.Alcohol WithdrawalA spectrum from tremor/anxiety to seizures and delirium tremens after stopping or cutting down alcohol in dependence. Benzodiazepines and thiamine are the mainstays; delirium tremens can be fatal.Acute Psychosis & ManiaAn acute disturbance with loss of contact with reality (delusions, hallucinations, disorganisation) and/or an elevated or irritable mood with overactivity. First priorities: keep everyone safe and exclude an organic (medical or drug) cause.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Treat the specific poisoning / underlying illness

📈 Treat the body and the mind

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Treat the specific poisoning / underlying illness

📈 Treat the body and the mind

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Treat the body and the mind

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Treat the body and the mind

References