14. Conception of medical
Thought death would be unlikely with medical attention
Was uncertain whether death could be averted by medical attention
Was certain of death even with medical attention
15. Degree of
Contemplated for 3 hours or less before attempt
Contemplated for more than 3 hours before attempt
SCORING: RISK: SUGGESTED MANAGEMENT PLAN:
0 -10 LOW May be sent home with advice to see Community Mental Health Team or GP
11 - 20 MEDIUM Assessment by Community Mental Health Team or Psychiatrist advisable.
If treatment refused, Community Mental Hea lth Team follow-up should be
Admission may be an option if patient:
• Lives alone
• Has a history of previous suicide attempt; or
• Is clinically depressed
20 - 30 HIGH Immediate assessment by Psychiatrist or Community Mental Health Team.
Psychiatric admission recommended.
Involuntary admission may be required.
ACTION TAKEN: (Tick box applicable)
Admitted: Medical Ward
Sent home: Alone
Referred to: Community Mental Health Team
NAME: _________________________________________ Signature: _____________________________