{
  "schema_version": 1,
  "kind": "condition",
  "id": "self-harm-risk",
  "name": "Self-Harm and Suicide Risk",
  "category": "chronic",
  "sources": "NICE Guideline NG225: Self-harm: assessment, management and prevention by non-specialists 2022 · NICE Clinical Guideline CG133: Longer-term management of self-harm 2011 · Suicide: Assessment and Management - StatPearls (NCBI Bookshelf NBK617057) - https://www.ncbi.nlm.nih.gov/books/NBK617057/: \"A safety plan is a brief intervention that can be implemented in any clinical setting to address modifiable risk factors.\" and \"High-risk patients requiring more restrictive measures to ensure safety, eg, an inpatient admission, must be deemed to be at imminent and significant risk of harm to themselves.\"",
  "review_status": "reviewed",
  "verified_against": "Suicide: Assessment and Management - StatPearls (NCBI Bookshelf NBK617057) - https://www.ncbi.nlm.nih.gov/books/NBK617057/: \"A safety plan is a brief intervention that can be implemented in any clinical setting to address modifiable risk factors.\" and \"High-risk patients requiring more restrictive measures to ensure safety, eg, an inpatient admission, must be deemed to be at imminent and significant risk of harm to themselves.\"",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1614,
      "generic": "Urgent psychiatric referral and crisis safety planning (No primary care drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "Conduct immediate suicide risk and psychosocial assessment. If acute imminent risk or medical self-harm/poisoning is present, arrange emergency department transport immediately. Do NOT prescribe lethal quantities of medications. Develop a collaborative crisis safety plan.",
      "adult_duration": "Immediate emergency referral",
      "dose_source": "Suicide: Assessment and Management - StatPearls (NCBI Bookshelf NBK617057) - https://www.ncbi.nlm.nih.gov/books/NBK617057/: \"A safety plan is a brief intervention that can be implemented in any clinical setting to address modifiable risk factors.\" and \"High-risk patients requiring more restrictive measures to ensure safety, eg, an inpatient admission, must be deemed to be at imminent and significant risk of harm to themselves.\"",
      "rationale": "Self-harm and acute suicidal ideation are psychiatric emergencies requiring immediate safety assessment and specialist intervention; drug therapy is not indicated as initial primary care treatment.",
      "cautions": [
        "TIME-CRITICAL EMERGENCY: Do not leave patient unattended if acute suicidal intent, active plan, or severe agitation is present.",
        "Do not prescribe large quantities of toxic drugs (e.g. TCAs, paracetamol, opioids, lithium); limit prescription duration to 7 days if any medication is essential.",
        "Remove access to lethal means (medications, firearms, sharp objects, ropes) immediately in consultation with family/carers.",
        "NG225 1.11.10 is explicit that there is no drug for this: do not offer drug treatment as a specific intervention to reduce self-harm. Treat the underlying condition if there is one; do not treat the self-harm."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Immediate emergency referral to pediatric psychiatry / CAMHS and emergency department for any child or adolescent presenting with self-harm or suicidal intent.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "self-harm-risk"
    }
  ]
}