Scope
Adults and children after self-harm, a suicide attempt or disclosure of suicidal thoughts in acute, primary or community care. Queensland’s PCCM and Suicide Prevention Practice Guideline provide the exact assessment and safety-planning pathway; the national ACSQHC standard supports continuity and clinical safety. This is not a national self-harm treatment CPG, and Queensland legal forms, detention powers and service contacts do not apply elsewhere.
The Bottom Line
- Treat poisoning, bleeding, strangulation, trauma or another physical consequence first while maintaining privacy, dignity and non-stigmatising care; medical stability does not remove the need for psychosocial assessment.
- Ask sensitively and directly about suicidal thoughts, desire, intent, planning, recent preparation, access to means, previous behaviour, current distress, substances, psychosis and reasons for living.
- Build an individual formulation from dynamic and historical risks, protective factors, culture, supports and foreseeable stressors; do not use a numerical score alone to declare a person safe or to determine discharge.
- Develop a collaborative written safety plan that identifies warning signs, immediate coping actions, people and services to contact and practical reduction of access to lethal means, and give the person and chosen support a usable copy.
- Arrange active transition and follow-up with named ownership, shared information and a response to missed contact; the national safety standard supports reliable continuity rather than passive advice to seek help if worse.
Practical clinical workflow
1
Stabilise injuries or exposure, obtain exact method and timing, contact the Poisons Information Centre or relevant emergency specialty when indicated and maintain observation proportionate to current risk.
2
Use a quiet safe setting, offer a support person where appropriate and complete a mental-state and psychosocial assessment that includes trauma, mental illness, substances, safeguarding, dependants, housing and access to means.
3
Formulate immediate and longer-term risks, decide capacity and the safest setting, and use the jurisdiction’s urgent mental-health and legal pathway when the person cannot engage in a viable safety plan.
4
Co-produce the safety and aftercare plan, reconcile medicines, restrict quantities or secure lethal means with consent and practical help, and connect the person to culturally appropriate clinical, peer and community support.
5
Transfer the assessment, physical treatment, safety plan and follow-up responsibilities directly to the next clinician or service and confirm how non-attendance or renewed risk will be handled.
Safety boundaries and escalation
- Current intent with means, a medically serious attempt, severe intoxication, psychosis, impaired capacity, violent behaviour, unsafe home conditions or inability to maintain observation requires urgent specialist or emergency care.
- A low apparent dose, superficial injury or denial of ongoing intent does not by itself establish safety; clarify delayed toxicity, concealment, escalating frequency and collateral concerns.
- Do not leave a person at imminent risk alone, and manage environmental hazards without punitive restraint or stigmatising language.
- Children, Aboriginal and Torres Strait Islander people, people in custody, people experiencing family violence and those leaving hospital require culturally and contextually appropriate pathways rather than a generic safety-plan template.
Implementation
The suicide assessment and practice documents are Queensland Health sources. Their clinical principles are visible here, but Queensland mental-health law, Emergency Examination Authorities and 1300 MH CALL are jurisdiction-specific. Outside Queensland, substitute the relevant state or territory law, crisis service and aftercare program. The ACSQHC Primary and Community Healthcare Clinical Safety Standard is national but does not create one national self-harm treatment pathway.
Clinical use boundary
This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.
Source documents
Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.
- Queensland Health and Royal Flying Doctor Service Queensland SectionPrimary Clinical Care Manual, 12th edition: Suicidal behaviour — adult/childISBN 978-1-876560-22-5 · 12th edition 2025, v1.03 with updates through 21 July 2026; section 5, printed pages 336–338 · accessed 2026-08-20view source
- Queensland Health, Clinical Excellence QueenslandSuicide Prevention Practice — Queensland Health GuidelineQH-GDL-967:2021 · QH-GDL-967:2021; retained in the current Queensland Health guideline register checked 2026-08-20 · accessed 2026-08-20view source
- Australian Commission on Safety and Quality in Health CarePrimary and Community Healthcare Clinical Safety StandardNational standard, updated 29 April 2026 · accessed 2026-08-20view source
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