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Confidentiality and self-harm — MRCPCH FOP MCQ

Instant feedback + full explanation. One question, done properly.

HardEthics, consent and communicationConfidentiality and self-harmMRCPCH FOP

A 14-year-old boy tells you he has been cutting his arms and has thoughts of taking an overdose tonight. He asks you not to tell his parents or anyone else. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: A — Explain the need to share information to keep him safe and arrange urgent mental health assessment

Imminent self-harm risk overrides confidentiality, so information should be shared proportionately to keep him safe and urgent assessment arranged. A promise of secrecy would be unsafe and misleading. Sleep advice may be helpful later but does not address immediate suicide risk. The pearl is to be transparent with young people about why confidentiality must be limited.

Reference: NICE NG225 Self-harm; GMC 0-18 years guidance