Patients at Risk of Further Harm

Patients may have co-existing medical and psychiatric conditions which necessitate admission to a general hospital, e.g. those having taken an overdose who require observation.

The Confidential Inquiry into Suicide and Homicide (CISH) has made recommendations on in-patient supervision and the environment required for those who pose a risk of further harm.

Recommendations [16].

Psychiatric and general hospitals, including EDs and observation wards, need to comply with these recommendations.

Key features of these recommendations include wards:

• Having no ligature points
• Eliminating physical obstructions that may impede observation of the high risk patient
• Increasing observations during the evening and night
• Conducting a risk assessment prior to discharge