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Staff Support Self-Harm — MRCPsych Paper B MCQ

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ModerateLiaison PsychiatryStaff Support Self-HarmMRCPsych Paper B

A 40-year-old woman attends the emergency department after a further episode of self-poisoning. During handover, several staff describe feeling frustrated and apprehensive about caring for her. According to NICE NG225, which is the most appropriate service response?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Provide regular formal supervision plus accessible senior and emotional support for staff

Explanation lettering: D = shown as B · B = shown as D

B is correct. NICE NG225 recommends regular, high-quality formal supervision for all staff working with people who self-harm. This should address the emotional impact of the work, include reflective practice and promote compassionate care. Staff should also have easily accessible senior support and access or signposting to emotional support. A is insufficient because occasional debriefing does not replace regular supervision. C wrongly limits support to routine managerial processes. D does not address the team's support needs and may disrupt continuity of care. E is punitive and risks reinforcing judgemental attitudes. Staff frustration should therefore prompt structured supervision and support while maintaining compassionate, clinically appropriate care.

Reference: National Institute for Health and Care Excellence. Self-harm: assessment, management and preventing recurrence (NG225), section 1.15, recommendations 1.15.1–1.15.2. 2022. https://www.nice.org.uk/guidance/ng225/chapter/recommendations