Dr. Shirley Sze (biography and disclosures)
What I did before
In the area of Non-Suicidal Self Injury, I had little knowledge to classify or deal effectively with this type of behaviour in patient encounters. Often times, these patients would be labelled as Borderline Personality Disorders and with this particular diagnoses, there was generally a lack of treatment options for them. Patients that exhibit this type of behaviour would often have repeated presentations of self injury that raised uncomfortable feelings in me as a family physicians due to gaps in understanding and knowledge about the condition. This lack of understanding of this type of behaviour allowed me to treat these patients only by being empathetic and dealing with their wounds.
What changed my practice
We had a presentation by Dr. Lyn MacBeath, one of our local psychiatrists on this topic which improved my knowledge of this condition especially from the patient’s perspective. I now recognize the inherent high risk of successful suicide (10%) in this population and the need to address non-suicidal self injury with the seriousness that it deserves. Dr. MacBeath has provided clinicians with guidelines to deal with patients that present with non-suicidal self-injury as well as hand-outs for patients. These are attached.
What I do now
I am certainly more aware of the increased risk for suicide in these patients and would make a point of asking about suicidality and following through with a Mental Health Assessment, appropriate treatment and referral for resources in mental health +/- addiction services.
I am also more aware that for a lot of these patients that they have problems verbally expressing some very difficult feelings and that often times, they are highly intelligent and artistic and assisting them in finding ways to verbally communicate effectively may eventually help them in their abstinence from self injury. The twelve step program for addictions seem to be an effective method.
Download Dr. Lyn MacBeath’s guidelines (View)
Download the patient information sheet (View)
References for the 10 % suicidal risk