6. Discharge considerations following ICU admission for poisoning
All patients who present to hospital with self-poisoning, by whatever means, should be referred for a psychiatric assessment from the self-harm team.
Some patients with predictable behaviour patterns have pre-existing psychiatric assessments that advise further assessment unnecessary should they represent with a further self-poisoning episode. However, a parasuicide necessitating ICU admission may warrant a change in patient management and referral should be made nonetheless.
In most circumstances, the above considerations are for the concern of the medical team to which a patient is discharged. In some circumstances though, an ICU provides a ‘safe’ environment in which to manage actively suicidal patients. The need for detention under the relevant mental health legislature and/or transfer to a secure mental health unit should therefore be considered before discharging a potentially at-risk patient to an open medical ward.