1. PSYCHIATRY / ALCOHOL AND DRUG FELLOWSHIP SAQ PRINCIPLES

2. SUICIDE RISK ASSESSMENT SAD PERSONS Sex – male1 Age - >55yr or youth1 Depression (PMH)2 Previous attempt1 Ethanol / drugs1 Rational thought loss2 Separated / divorced / widowed1 Organised plan / serious attempt2 No supports1 Sickness (organic)2 8 high risk

3. RISK STRATIFICATION OF SUICIDE ATTEMPT IPMO Intent Plan Motivation Opportunity Risk:Resue ratio  Lethality vs publicity

4. DEPRESSIVE ILLNESS IN SAD CAGES Interest Sleep Appetite Depressed mood Concentration Activity Guilt Energy Suicidal ideation Major depression >=5/9 for >=2 weeks

5. VIOLENT PATIENT Safety  Self, staff, other patients, violent patient Strategies approach  Recognition - PHx, current Hx, drugs and EtOH  prevent escalation – see early, show force, set limits, up triage, area Restraint  Verbal, show of force, physical 6 pt arrow, chemical PO IM IV Safe disposition  Inpatient, outpatient Continued quality improvement  CISD  Future prevention violence – ED design, control access, education, undress all patients EXCLUDE ORGANIC CAUSE!!