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Self-harm – risk assessment — RACP Paediatrics MCQ

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ModerateEmergencySelf-harm – risk assessmentRACP Paediatrics

A 13-year-old presents with self-harm (superficial cutting) but denies suicidal intent. She has been experiencing bullying at school. There are no features of depression. Wounds are superficial and do not require suturing. What is the most appropriate management?

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Correct answer: B — Risk assessment and safety planning

A comprehensive psychosocial risk assessment (including HEEADSSS assessment) with safety planning is the most important step. Superficial self-harm without suicidal intent requires understanding the underlying distress (bullying in this case), wound care, safety planning, and appropriate follow-up (CAMHS, school counselling, or GP mental health plan). Emergency psychiatric admission is not indicated for non-suicidal self-harm with adequate supports.

Reference: RCH Melbourne – 2023 – Mental Health Emergency CPG; RACP Paediatric Curriculum – Adolescent Medicine