Suicidnära patienter - Stockholms läns landsting

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Regionalt vårdprogram – Suicidnära patienter Innehållsförteckning Förord.................................................................................................................................3 1. Inledning.....................................................................................................................6 2. Epidemiologi.............................................................................................................8 3. Bedömning av suicidrisk.................................................................................12 Rekommendationer.........................................................................................................12 Dokumentation av riskbedömning..................................................................................14 4. Tillstånd med ökad risk för suicid..............................................................15 Tidigare suicidförsök......................................................................................................15 Schizofreni och annan psykossjukdom...........................................................................18 Depression och bipolär sjukdom....................................................................................20 Missbruk/beroende.........................................................................................................23 Utvecklingsrelaterade kognitiva funktionsnedsättningar...............................................26 Personlighetsstörning......................................................................................................27 Somatisk sjukdom...........................................................................................................30 5. Andra faktorer.......................................................................................................31 Kön.................................................................................................................................31 Ärftlighet.........................................................................................................................31 Födelseland.....................................................................................................................32 Äldre...............................................................................................................................33 Unga vuxna.....................................................................................................................34 HBT-personer..................................................................................................................35 Kriminalvård...................................................................................................................35 6. Vårdriktlinjer..........................................................................................................37 Familj och andra närstående...........................................................................................40 7. Slutenvård................................................................................................................42 Patientsäkerhet................................................................................................................42 Visitering.........................................................................................................................42 Extravak..........................................................................................................................43 Att tänka på vid extravak och extratillsyn......................................................................43 Checklista.......................................................................................................................43 Övriga interventioner vid suicidrisk...............................................................................44 Att arbeta med suicidnära personer.................................................................................44 8. Tvångsvård..............................................................................................................45 9. Psykologisk behandling...................................................................................47 Medicinskt programarbete, Stockholms läns landsting – 4 –
Regionalt vårdprogram – Suicidnära patienter 10. Primärvård............................................................................................................49 11. Efter suicid i vården........................................................................................51 Patientsäkerhet................................................................................................................51 Händelseanalys...............................................................................................................51 Händelseanalys efter suicid............................................................................................51 Lex Maria........................................................................................................................52 Stöd till anhöriga.............................................................................................................52 Stöd till personalen.........................................................................................................53 12. Kvalitetsindikatorer.........................................................................................55 13. Bilagor.....................................................................................................................56 Bilaga 1: Minneslista - suicidriskbedömning för patient som inte gjort aktuellt försök.................................................................................................................56 Bilaga 2: Ett urval av variabler från Scale for Suicide Ideation....................................57 Bilaga 3: Suicidal intent scale.........................................................................................58 Bilaga 4: SPOC – Suicidal Patient Observation Chart...................................................60 Referenser......................................................................................................................61 Medicinskt programarbete, Stockholms läns landsting – 5 –
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Suicidnära patienter - Stockholms läns landsting

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