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Chapter 15 - Psychological Approaches to the Acute Patient in PICUs

Published online by Cambridge University Press:  15 March 2024

By
Marc Jonathon Kingsley
Edited by
Roland Dix ,
Stephen Dye  and
Stephen M. Pereira
Roland Dix
Affiliation:
Gloucestershire Health and Care NHS Foundation Trust, Gloucester
Stephen Dye
Affiliation:
Norfolk and Suffolk Foundation Trust, Ipswich
Stephen M. Pereira
Affiliation:
Keats House, London
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Summary

This chapter highlights some important features of psychological work within the context of acute psychiatric services, specifically psychiatric intensive care unit (PICU) settings. A psychological perspective offers a valuable opportunity for mental health professions to investigate the holistic experience of ward culture and patient treatment on such wards. This chapter explores some of the key roles of a clinical psychologist on a PICU, including offering psychological assessments, psychological therapy and management to patients and their families. A relational and developmental model is used, in line with object-relations theorists such as Winnicott and Casement. The chapter reflects on the role of psychologists in offering staff support and encouraging psychological safety on wards. It explores specific challenges to psychological work on acute wards will be explored, including working with the involuntary status of patients, and the complexity and risk to self and others inherent to presentations in acute settings.

Keywords

anger managementcontainmentfamily dynamicshopelessnesspsychological assessmentpsychological mindednesssafetytherapy
Type
Chapter
Information
Psychiatric Intensive Care , pp. 187 - 204
Publisher: Cambridge University Press
Print publication year: 2024

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References

Angelakis, I, Gillespie, EL and Panagioti, M (2019) Childhood Maltreatment and Adult Suicidality: A Comprehensive Systematic Review with Meta-Analysis. Psychological Medicine 49 (7) 1057–78.CrossRefGoogle ScholarPubMed
Beck, AT, Brown, G, Berchick, RJ, Stewart, BL and Steer, RA (1990) Relationship between Hopelessness and Ultimate Suicide: A Replication with Psychiatric Outpatients. American Journal of Psychiatry 147 (2) 190–5.Google ScholarPubMed
Beck, AT, Brown, G and Steer, RA (1989) Prediction of Eventual Suicide in Psychiatric Inpatients by Clinical Ratings of Hopelessness. Journal of Consulting and Clinical Psychology 57 (2) 309–10.CrossRefGoogle ScholarPubMed
Beck, AT, Steer, RA, Kovacs, M and Garrison, B (1985) Hopelessness and Eventual Suicide: a 10-year Prospective Study of Patients Hospitalized with Suicidal Ideation. American Journal of Psychiatry 142 (5) 559–63.Google ScholarPubMed
Bem, SL. (1981) Gender Schema Theory: A Cognitive Account of Sex Typing. Psychological Review 88 (4) 354–64.CrossRefGoogle Scholar
Borecky, A, Thomsen, C and Dubov, A (2019) Reweighing the Ethical Tradeoffs in the Involuntary Hospitalization of Suicidal Patients. American Journal of Bioethics 19 (10) 71–83. DOI: https://10.1080/15265161.2019.1654557.CrossRefGoogle ScholarPubMed
Bradshaw, J (1991) Homecoming. New York: Piatkus.Google Scholar
Braga, T, Cunha, O and Maia, A (2018) The Enduring Effect of Maltreatment on Antisocial Behavior: A Meta-Analysis of Longitudinal Studies. Aggression and Violent Behavior 40: 91–100.CrossRefGoogle Scholar
British Psychological Society (BPS) (2012) Commissioning and Delivering Clinical Psychology in Acute Adult Mental Health Care.Google Scholar
Buchanan, A, Sint, K, Swanson, J and Rosenheck, R (2019) Correlates of Future Violence in People Being Treated for Schizophrenia. American Journal of Psychiatry 176 (9) 694–701. DOI: https://doi.org/10.1176/appi.ajp.2019.18080909.CrossRefGoogle ScholarPubMed
Carers Trust Professionals (2015) Triangle of Care Toolkit – A Resource for Mental Health Service Providers. (online) https://www.carers.org/resources/all-resources/60-the-triangle-of-care-toolkit-a-a-resource-for-mental-health-service-providers-introduction.Google Scholar
Casement, P (1985) On Learning from the Patient. London: Routledge.Google Scholar
Chaudhry, K, Kingsley, M and Ghafur, S (2006) The Anger Management Group at Pathways PICU. National Association of Psychiatric Intensive Care Units Bulletin 4: 19–21.Google Scholar
Cheng, E (2021) Iatrogenic Trauma – What is It? Beyond the Cycle of Trauma Institute. www.beyond-the-cycle-of-trauma.org/for-physicians-and-nurses/iatrogenic-trauma-what-is-it.Google Scholar
Clinton, C (2000) Pathways PICU. [Unpublished survey] Goodmayes Hospital, Essex.Google Scholar
Cusack, P, Cusack, FP, McAndrew, S, McKeown, M and Duxbury, J (2018) An Integrative Review Exploring the Physical and Psychological Harm Inherent in Using Restraint in Mental Health Inpatient Settings. International Journal of Mental Health Nursing 27 (3) 1162–76. DOI: https://doi.org/10.1111/inm.12432.CrossRefGoogle ScholarPubMed
Dawson, P, Galis, A, Hughes, L and O’Shaughnessy, M (2003) Development of an Anger Management Group Programme in PICU [Unpublished manuscript]. Pathways PICU. Goodmayes Hospital, Essex.Google Scholar
Dawson, P, Kingsley, M and Pereira, S (2005) Violent Patients within Psychiatric Intensive Care Units: Treatment Approaches, Resistance and the Impact Upon Staff. Journal of Psychiatric Intensive Care 1 (1) 45–53.CrossRefGoogle Scholar
Department of Health (2002) The National Suicide Prevention Strategy for England. London: Department of Health.Google Scholar
Dewar, S (1999) Clinical Governance Under Construction. London: Kings Fund.Google Scholar
Dirik, A, Sandhu, S, Giacco, D, Barrett, K, Bennison, G, Collinson, S, et al. (2017) Why Involve Families in Acute Mental Healthcare? A Collaborative Conceptual Review. BMJ Open 7 (9) e017680. DOI: https://10.1136/bmjopen-2017-017680.CrossRefGoogle ScholarPubMed
Docker-Drysdale, B (1991) The Provision of Primary Experience: Winnicottian Work with Children and Adolescents. New Jersey: Jason Aronson.Google Scholar
Durrant, C, Clarke, I, Tolland, A and Wilson, H (2007) Designing a CBT Service for an Acute Inpatient Setting: A Pilot Evaluation Study. Clinical Psychology and Psychotherapy 14 (2) 117–25.CrossRefGoogle Scholar
Evans, M, Morgan, HG, Hayward, A and Gunnell, DJ (1999) Crisis Telephone Consultation for Deliberate Self-Harm Patients: Effects on Repetition. British Journal of Psychiatry 175: 23–7.CrossRefGoogle ScholarPubMed
Faddon, G, Bebbington, P and Kuipers, L (1987) The Burden of Care: The Impact of Functional Psychiatric Illness on the Patient’s Family. British Journal of Psychiatry 150: 285–92.Google Scholar
Flett, GL and Hewitt, PL (eds.) (1994) Perfectionism: Theory, Research and Treatment. Washington DC: American Psychological Association.Google Scholar
Fosse, R, Eidhammer, G, Selmer, LE, Knutzen, M and Bjørkly, S (2021) Strong Associations Between Childhood Victimization and Community Violence in Male Forensic Mental Health Patients. Frontiers in Psychiatry 11: 628734. DOI: https://doi.org/10.3389/fpsyt.2020.628734.CrossRefGoogle ScholarPubMed
Foster, T (2011) Adverse Life Events Proximal to Adult Suicide: A Synthesis of Findings from Psychological Autopsy Studies. Archives of Suicide Research 15 (1) 1–15.CrossRefGoogle ScholarPubMed
Gabbard, GO (1994) Psychodynamic Psychiatry in Clinical Practice. Washington, DC: American Psychiatric Press.Google Scholar
Goldstein, MJ (1999) Psychological Approaches to Management of Violence. Paper delivered at King George Hospital, Goodmayes, Essex.Google Scholar
Grandison, G, Karatzias, T, Fyvie, C, Hyland, P, O’Connor, RC and Dickson, A (2020) Suicidal Histories in Adults Experiencing Psychological Trauma: Exploring Vulnerability and Protective Factors. Archives of Suicide Research 26 (1) 1–14. DOI: https://doi.org/10.1080/13811118.2020.1758262.Google ScholarPubMed
Hachtel, H, Harries, C, Luebbers, S and Ogloff, JR (2018) Violent Offending in Schizophrenia Spectrum Disorders Preceding and Following Diagnosis. The Australian and New Zealand Journal of Psychiatry 52 (8) 782–92. DOI: https://doi.org/10.1177/0004867418763103.CrossRefGoogle ScholarPubMed
Hanna, J (2006) Psychology on the Wards. Star Wards. www.starwards.org.uk/psychology-on-the-wards.Google Scholar
Harriss, L and Hawton, K (2005) Suicidal Intent in Deliberate Self-Harm and the Risk of Suicide: The Predictive Power of the Suicide Intent Scale. Journal of Affective Disorders 86 (2) 225–33.CrossRefGoogle ScholarPubMed
Hawton, K and Fagg, J (1988) Suicide, and Other Causes of death, Following Attempted Suicide. British Journal of Psychiatry 152: 359–66.CrossRefGoogle ScholarPubMed
Hawton, K, Townsend, E, Arensman, E, Gunnell, P, House, K and van Heeringen, K (2000) Psychosocial and Pharmacological Treatments for Deliberate Self-Harm. Cochrane Database of Systematic Reviews (2): CD001764.Google ScholarPubMed
Heisel, MJ, Flett, GL and Hewitt, PL (2003) Social Hopelessness and College Student Suicide Ideation. Arch Suicide Res 7 (3) 221–35.CrossRefGoogle Scholar
Heisel, MJ and Marnin, J (2004) Suicide Ideation in the Elderly. Psychiatric Times 21 (3).Google Scholar
Hewitt, PL, Norton, GR, Flett, GL, Callander, L and Cowan, T (1998) Dimensions of Perfectionism, Hopelessness, and Attempted Suicide in a Sample of Alcoholics. Suicide & Life-Threatening Behavior 28 (4) 395–406.CrossRefGoogle Scholar
Hinshelwood, RD (1999) The Difficult Patient. The Role of ‘Scientific Psychiatry’ in Understanding Patients with Chronic Schizophrenia or Severe Personality Disorder. British Journal of Psychiatry 174: 187–90.CrossRefGoogle ScholarPubMed
Itzhaki, M, Bluvstein, A, Bortz, P, Kostistky, H, Bar Noy, D, Filshtinsky, V, et al. (2018) Mental Health Nurse’s Exposure to Workplace Violence Leads to Job Stress, Which Leads to Reduced Professional Quality of Life. Frontiers in Psychiatry 9: 59. DOI: https://doi.org/10.3389/fpsyt.2018.00059/.CrossRefGoogle ScholarPubMed
Kaplan, HI, Sadock, B and Grebb, J (1994) Synopsis of Psychiatry, 7th ed. Baltimore, MD: Williams and Wilkins.Google Scholar
Karatzias, T, Hyland, P, Bradley, A, Cloitre, M, Roberts, NP, Bisson, JI, et al. (2019) Risk Factors and Comorbidity of ICD-11 PTSD and Complex PTSD: Findings from a Trauma-Exposed Community Sample of Adults in the United Kingdom. Depression and Anxiety 36 (9) 887–94. DOI: https://doi.org/10.1002/da.22934.CrossRefGoogle Scholar
Kernberg, OF (1975) Borderline Conditions and Pathological Narcissism. New Jersey: Jason Aronson.Google Scholar
The Kings Fund (2015) Patients’ Experience of Using Hospital Services: An Analysis of Trends in Inpatient Surveys in NHS Acute Trusts in England 2005–13. (online) www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Patients-experience-Kings-Fund-Dec-2015.pdf.Google Scholar
Knight, C (2015) Trauma-Informed Social Work Practice: Practice Considerations and Challenges. Clinical Social Work Journal 43: 25–37.CrossRefGoogle Scholar
Leather, JZ, O’Connor, RC, Quinlivan, L, Kapur, N, Campbell, S and Armitage, CJ (2020) Healthcare Professionals’ Implementation of National Guidelines with Patients Who Self-Harm. Journal of Psychiatric Research 130: 405–11. DOI: https://doi.org/10.1016/j.jpsychires.2020.08.031.CrossRefGoogle ScholarPubMed
Linehan, MM, Goodstein, JL, Nielsen, SL and Chiles, JA (1983) Reasons for Staying Alive When You are Thinking of Killing Yourself: The Reasons for Living Inventory. Journal of Consulting and Clinical Psychology 51 (2) 276–86.CrossRefGoogle ScholarPubMed
MacLeod, AK, Tata, P, Tyrer, P, Schmidt, U, Davidson, K and Thompson, S (2005) Hopelessness and Positive and Negative Future Thinking in Parasuicide. British Journal of Clinical Psychology 44 (4): 495–504.CrossRefGoogle ScholarPubMed
Malone, KM, Oquendo, MA, Haas, GL, Ellis, SP, Li, S and Mann, JJ (2000) Protective Factors against Suicidal Acts in Major Depression: Reasons for Living. American Journal of Psychiatry 157 (7) 1084–8.CrossRefGoogle ScholarPubMed
Mann, JJ, Waternaux, C, Haas, GL and Malone, KM (1999) Toward a Clinical Model of Suicidal Behaviour in Psychiatric Patients. American Journal of Psychiatry 156 (2): 181–9.CrossRefGoogle Scholar
Mervis, J (1999) Workshop on Loss and Grief. Presented to Mental Health Professionals at Tara Hospital. Gauteng, South Africa.Google Scholar
Miller, A (1987) For Your Own Good. London: Virago.Google Scholar
Miller, A (1995) The Drama of Being a Child: The Search for the True Self. London: Virago.Google Scholar
Milnes, D, Owens, D and Blenkiron, P (2002) Problems Reported by Self-Harm Patients: Perception, Hopelessness, and Suicidal Intent. Journal of Psychosomatic Research 53 (3) 819–22.CrossRefGoogle ScholarPubMed
Mind (2017) Ward Watch: Mind’s Campaign to Improve Hospital Conditions for Mental Health Patients. Mind: London.Google Scholar
National Association of Psychiatric Intensive Care and Low Secure Units (NAPICU) (2014) National Minimum Standards for Psychiatric Intensive Care in General Adult Services. (online) https://napicu.org.uk/wp-content/uploads/2014/12/NMS-2014-final.pdf.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2016) Transition between Inpatient Mental Health Settings and Community or Care Home Settings. National guideline [NG53]. (online) www.nice.org.uk/guidance/ng53.Google Scholar
NHS Employers (2018) NHS Health and Well-Being Framework. (online) www.nhsemployers.org/case-studies-and-resources/2018/05/nhs-health-and-wellbeing-framework/.Google Scholar
NHS England (2021) 2021/22 Priorities and Operational Planning Guidance. (online) www.england.nhs.uk/publication/2021-22-priorities-and-operational-planning-guidance/.Google Scholar
Nitsun, M (1996) The Anti-Group: Destructive Forces in the Group and their Creative Potential. London: Routledge.CrossRefGoogle Scholar
Nuij, C, van Ballegooijen, W, Juniar, D, Erlangsen, A, Portzky, G, O’Connor, RC, et al. (2021) Safety Planning-type Interventions for Suicide Prevention: Meta-Analysis. British Journal of Psychiatry 219 (2) 419–26.CrossRefGoogle ScholarPubMed
O’Connor, RC and Kirtley, OJ (2018) The Integrated Motivational-Volitional Model of Suicidal Behaviour. Philosophical Transactions of the Royal Society of London 373(1754) 20170268. DOI: https://doi.org/10.1098/rstb.2017.0268.CrossRefGoogle ScholarPubMed
O’Connor, RC and Portzky, G (2018) The Relationship between Entrapment and Suicidal Behavior through the Lens of the Integrated Motivational–Volitional Model of Suicidal Behavior. Current Opinion in Psychology 22: 12–17. DOI: https://doi.org/10.1016/j.copsyc.2017.07.021.CrossRefGoogle ScholarPubMed
O’Connor, DB, Gartland, N and O’Connor, RC (2020) Stress, Cortisol and Suicide Risk. International Review of Neurobiology 152: 101–30.CrossRefGoogle ScholarPubMed
Oakley, C, Harris, S, Fahy, T, Murphy, D and Picchioni, M (2016) Childhood Adversity and Conduct Disorder: A Developmental Pathway to Violence in Schizophrenia. Schizophrenia Research 172 (1–3) 54–9. DOI: https://doi.org/10.1016/j.schres.2016.01.047.CrossRefGoogle ScholarPubMed
Ostman, T and Wallsten, KL (2005) Family Burden and Relatives’ Participation in Psychiatric Care: Are the Patient’s Diagnosis and the Relation to the Patient of Importance? International Journal of Social Psychiatry 51(4): 291–301.CrossRefGoogle Scholar
Owens, D, Dennis, M, Read, S and Davis, N (1994) Outcome of Deliberate Self-Poisoning. An Examination of Risk Factors for Repetition. British Journal of Psychiatry 165 (6) 797–801.CrossRefGoogle ScholarPubMed
Owens, D, Horrocks, J and House, A (2002) Fatal and Non-fatal Repetition of Self-Harm: Systematic Review. British Journal of Psychiatry 181: 193–9.CrossRefGoogle ScholarPubMed
Paterson, C, Karatzias, T, Harper, S, Dougall, N, Dickson, A and Hutton, P (2018) A Feasibility Study of a Cross‐Diagnostic, CBT‐Based Psychological Intervention for Acute Mental Health Inpatients: Results, Challenges, and Methodological Implications. British Journal of Clinical Psychology 58 (2) 211–30.Google ScholarPubMed
Petrie, K, Chamberlain, K and Clarke, D (1988) Psychological Predictors of Future Suicidal Behaviour in Hospitalized Suicide Attempters. British Journal of Clinical Psychology 27 (3) 247–58.CrossRefGoogle ScholarPubMed
Priebe, S (2019) Involuntary Hospitalization of Suicidal Patients: Time for New Answers to Basic Questions?. American journal of Bioethics 19 (10) 90–2. DOI: https://10.1080/15265161.2019.1654033.CrossRefGoogle ScholarPubMed
Radcliffe, J and Bird, L (2016) Talking Therapy Groups on Acute Psychiatric Wards: Patients’ Experience of Two Structured Group Formats. BJPsych Bulletin 40(4) 187–91.CrossRefGoogle ScholarPubMed
Razzaque, R and Stockmann, T (2016) An Introduction to Peer-supported Open Dialogue In Mental Healthcare. Advances In Psychiatry Treatment 22 (5): 348–56.Google Scholar
The Regulation and Quality Improvement Authority (2014–15) A Review of Acute Mental Health Inpatient Access to Psychological Interventions and Therapies. (online) www.rqia.org.uk/RQIA/files/aa/aaa0a727-0801-4e30-9947-313acef111a1.pdf.Google Scholar
Robin, S and Novaco, RW (1999) Systems Conceptualisation and Treatment of Anger. Journal of Clinical Psychology 55 (3) 325–37.Google Scholar
Royal College of Psychiatrists (2017) Standards for Inpatient Mental Health Services. (online) www.rcpsych.ac.uk›default-source›ccqi›quality-networks›aims/.Google Scholar
Salter, D and Platt, S (1990) Suicidal Intent, Hopelessness and Depression in a Parasuicide Population: The Influence of Social Desirability and Elapsed Time. British Journal of Clinical Psychology 29 (4) 361–71.CrossRefGoogle Scholar
Seager, M (2006) The Concept of ‘Psychological Safety’ – A Psychoanalytically Informed Contribution Towards ‘Safe, Sound & Supportive’ Mental Health Services. Psychoanalytic Psychotherapy 20 (4) 266–80.CrossRefGoogle Scholar
Sidley, GL, Callam, R, Wells, A, Hughes, T and Whitaker, K (1999) The Prediction of Parasuicide Repetition in a High risk Group. British Journal of Clinical Psychology 38 (4) 375–86.CrossRefGoogle ScholarPubMed
Sinclair, J and Hawton, K (2004) Suicide and Deliberate Self-Harm. In Guthrie, E (ed.), Handbook of Liaison Psychiatry. Cambridge: Cambridge University Press.Google Scholar
Small, C, Huddy, V and Williams., C (2018) Individual Psychological Therapy in an Acute Inpatient Setting: Service User and Psychologist Perspectives. Psychology and Psychotherapy 91 (4) 417–33.CrossRefGoogle Scholar
Sutherby, K, Szmukler, GI, Halpern, A, Alexander, G, Thornicroft, G, Johnson, C, et al. (1999) A Study of ‘Crisis Cards’ in a Community Psychiatric Service. Acta Psychiatrica Scandinavica 100 (1) 56–61.CrossRefGoogle Scholar
Sweeney, A, Clement, S, Filson, B and Kennedy, A (2016) Trauma-Informed Mental Healthcare in the UK: What Is It and How Can We Further its Development? Mental Health Review Journal 21 (3) 174–92.CrossRefGoogle Scholar
Sweeney, A, Filson, B, Kennedy, A, Collinson, L and Gillard, S (2018) A Paradigm Shift: Relationships in Trauma-Informed Mental Health Services. BJPsych Advances 24 (5) 319–33. DOI: https://doi.org/10.1192/bja.2018.29.CrossRefGoogle ScholarPubMed
Szanto, K, Reynolds, CF, Conwell, Y, Begley, AE and Houck, P (1998) High Levels of Hopelessness Persist in Geriatric Patients with Remitted Depression and a History of Suicide Attempt. Journal of the American Geriatric Society 46 (11) 1401–6.CrossRefGoogle Scholar
Szasz, T (1998) The Involuntary Patient. British Journal of Psychiatry 15: 216–25.Google Scholar
Theodoridou, A, Schlatter, F, Ajdacic, V, Rössler, W and Jäger, M (2012) Therapeutic relationship in the context of perceived coercion in a psychiatric population. Psychiatry Research 200 (2–3) 939–44. DOI: https://10.1016/j.psychres.2012.04.012.CrossRefGoogle Scholar
Townsend, E, Hawton, K, Altman, DG, Arensman, E, Gunnell, D, Hazell, P, et al. (2001) The Efficacy of Problem-Solving Treatments after Deliberate Self-Harm: Meta-Analysis of Randomised Controlled Trials with Respect to Depression, Hopelessness and Improvement in Problems. Psychological Medicine 31 (6) 979–88.CrossRefGoogle ScholarPubMed
Wallace, ER (1983) Dynamic Psychiatry in Theory and Practice. Philadelphia: Lea & Febiger.Google Scholar
Watson, AC and Angell, B (2013) The Role of Stigma and Uncertainty in Moderating the Effect of Procedural Justice on Cooperation and Resistance in Police Encounters with Persons with Mental Illnesses. Psychology, Public Policy, and Law 19 (1) 30–9. DOI: https://doi:10.1037/a0027931.CrossRefGoogle ScholarPubMed
Watts, D and Morgan, G (1994) Malignant Alienation: Dangers for Patients Who Are Hard to Like. British Journal of Psychiatry 164 (1) 11–15.CrossRefGoogle Scholar
Wetzel, RD, Margulies, T, Davis, R and Karam, EI (1980) Hopelessness, Depression, and Suicidal Intent. Journal of Clinical Psychiatry 41 (5) 159–60.Google Scholar
Winnicott, DW (1971) Playing and Reality. New York: Basic Books.Google Scholar
Winnicott, DW (1975) Through Paediatrics to PsychoAnalysis. New York: Basic Books.Google Scholar
Winnicott, DW (1984) The Antisocial Tendency. In Winnicott, C, Shepherd, R and Davis, M (eds.), Deprivation and Delinquency. London: Tavistock Publications. pp. 120–31.Google Scholar
Witt, K, van Dorn, R and Fazel, S (2013) Risk Factors for Violence in Psychosis: Systematic Review and Meta-Regression Analysis of 110 Studies. PLoS ONE 8 (2) e55942. DOI: https://doi.org/10.1371/journal.pone.0055942.CrossRefGoogle ScholarPubMed
Wood, L, Williams, C, Billings, J and Johnson, S (2018) The Role of Psychology in a Multidisciplinary Psychiatric Inpatient Setting: Perspective from the Multidisciplinary Team. Psychology and Psychotherapy 92 4 554–64). DOI: https://europepmc.org/article/MED/29345801.Google Scholar
Zahl, D and Hawton, K (2004) Repetition of Deliberate Self-Harm and Subsequent Suicide Risk: Long-Term Follow-up Study of 11583 Patients. British Journal of Psychiatry 185: 70–5.CrossRefGoogle Scholar
Zortea, TC, Cleare, S, Melson, AJ, Wetherall, K and O’Connor, RC (2020) Understanding and Managing Suicide Risk. British Medical Bulletin 134 (1) 73–84. DOI: https://doi.org/10.1093/bmb/ldaa013.CrossRefGoogle ScholarPubMed

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