Department of Health

Key messages

  • Treatment plans for people at risk of suicide are vital and should always be prepared with the person and their family and supporters (as appropriate).
  • Personal information is often necessary to formulate an effective treatment plan and informed consent should be sought.
  • Inpatient treatment does not always prevent suicide but it is important to consider and provide the necessary level of care.
  • Maintaining documentation and keeping treatment plans up to date is vital.

The treatment and care of a person at risk of suicide should always be appropriate to their assessed level of risk.

Preparing a treatment plan

Treatment plans should include written information regarding available community resources (for example, help lines), dates of review appointments, and specific services to contact in a crisis. If the person provides informed consent, family members and supporters should be given a copy of the plan , advised to remove any means of self-harm within the home, and asked to monitor the person’s whereabouts and any sudden changes in their behaviour.

Involve the person in preparation of the treatment plan

It is vital to involve the person in the preparation of any treatment plan, providing them with both written and verbal information about the nature and purpose of the treatment they are being offered. This can help to alleviate pressure on people who may be incapable of making important healthcare decisions due to their distress. Family and supporters should also be involved in preparation of treatment plans (as appropriate) and with the informed consent of the person.

Understand level of support available

Careful consideration should be given to the degree of support available to the person and the level of risk. Although people facing acute suicide risk are generally better managed in an inpatient environment, the Mental Health and Wellbeing Act 2022 requires preference to be given to the least restrictive approach to treatment and care. Where appropriate for the level of risk, a home-based treatment plan may be appropriate. Home-based plans require detailed evaluation of the person’s home environment and social supports, to gauge levels of personal support as well as potential stress factors.

Collecting information

In the case of suicidal behaviour, the level of risk will require broader enquiry into a person’s living and family circumstances, as well as other stressors that may be present in the person’s life. Collection of information from the person’s family or other service providers is governed by the Health Records Act 2001 and the Health Privacy Principles, which relate to consent and the need to collect information to prevent or mitigate a serious threat to a person’s life. For more information please see MHW Act 2022 Information Sharing.

The Mental Health and Wellbeing Act 2022 adopts a consent-driven approach to information sharing. As a general rule, consumer consent is required for the sharing of health and personal information, and consumers are able to withdraw this consent at any time.

The Act includes a positive duty for providers to share some or all of a person's health information to family, a carer or a supporter, if a consumer has consented to the sharing of that information, following the consumer's admission or discharge from an inpatient service.

There are some circumstances where the sharing of information be overridden and where health information can be disclosed without consent. For more information please see MHW Act 2022 Information SharingExternal Link .

Managing inpatients

When a person is acutely suicidal or has severe psychiatric illness or inadequate social supports, there is a clear need for inpatient management and close supervision. It is important to remember that inpatient management does not always prevent suicide, which can occur in inpatient settings or during day leave.

Determining the level of supervision

Depending on the acuity of risk, the level of supervision may range from management in a high-dependency area to continuous one-to-one observation by a staff member.

Compulsory treatment

The Mental Health and Wellbeing Act 2022 requires that voluntary assessment and treatment is preferred over compulsory approaches wherever possible.

A person subject to an assessment order may only be given treatment for their apparent mental illness if:

  • they give informed consent to the treatment (the Act includes specific requirements in relation to informed consent); or
  • where the treatment is required as a matter of urgency to prevent serious deterioration in their mental or physical health or serious harm to the person or another person.

If the person is not mentally ill within the meaning of the Act, the clinician should document the clinical basis for their diagnosis, together with the nature of the treatment and care offered, and contact family and friends so that they can provide informed support.

Maintaining documentation

Careful and detailed documentation is particularly critical to keep clinical staff and caregivers informed of the continuing assessment and management of people facing a suicide risk.

Keep the treatment plan up to date

As levels of risk can fluctuate, a treatment plan should be kept up to date with the most current information available, including actual and proposed treatments and their clinical basis, medications, tests, precautions or contra-indications, and plans for follow-up assessments.

Treatment plans should also include records of all assessments, clinical decisions, consultations and referrals, as well as the person’s personal contacts, a list of care providers and a detailed record of contacts with them.

Reviewed 05 September 2023


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