Reducing suicide and deliberate self-harm in mental health in patient units

Recommendations have been made in the coronial jurisdiction following an inquest into the death of a patient in a declared mental health inpatient unit. These are of interest to those in mental health services as they provide useful guidelines and initiatives for the improvement of services and risk management.

The Coroner stated that mental health in-patient facilities are encouraged to have in place policies and procedures to ensure:

1. an appropriate skill mix of nursing staff in mental health units to ensure adequate patient engagement and observation;
2. communication amongst all mental health staff regarding the changing of patient observation level and status and the reasons for this;
3. the clear identification of staff assigned responsibility for individual patient care and recording of observations;
4. documentation of patient engagement and observation contemporaneously as opposed to “block recording”;
5. regular auditing to ensure adherence to policy and procedure; and
6. ongoing education programs to enhance development and maintenance of procedural knowledge and skill sets.

Of note, the Ministry of Health has granted funding to the Black Dog Institute for a clinical trial of back-to-base pulse oximetry for those considered to be at active risk of suicide to allow a reliable technological back-up to nursing engagement.

Post by Claudine Watson-Kyme and Karen Kumar