Self-Harm Assessment — MRCPsych Paper B MCQ

Correct answer: D — A psychosocial assessment by a mental health professional

The correct answer is D. NICE NG225 recommends psychosocial assessment by a mental health professional at the earliest opportunity after self-harm. A person attending the emergency department should be referred promptly to liaison psychiatry or an equivalent suitably skilled professional, alongside physical care. The assessment explores the function and context of the self-harm, current mental state, needs, vulnerabilities, protective factors and safety considerations. Emotionally unstable personality disorder does not remove this requirement; each episode must be assessed in its own right. GP follow-up alone is insufficient. Psychiatric admission is determined by individual clinical and legal indications rather than being routine. Social-care referral is appropriate only when relevant needs or safeguarding concerns are identified. Benzodiazepines neither replace assessment nor constitute routine treatment for self-harm.

Reference: National Institute for Health and Care Excellence. Self-harm: assessment, management and preventing recurrence. NICE guideline NG225, sections 1.5 and 1.7, 2022; last reviewed 2024. https://www.nice.org.uk/guidance/ng225/chapter/recommendations