Studying post grad degree but working part time - has she got a work life balance? Is she over working herself? Is she burnt out? Has she got a goof work life balance?

History of PTSD following sexual assault in late teens - Has she had a follow up? Is there any support after this?

Previously engaged in trauma - engaged in CBT and was discharged from phycological services a year ago. - should she go back to engaging in CBT or any other services?

Escalating suicidal thoughts and severe intrusive memories

Feels overwhelmed and unable yo keep herself safe. - does she need a GP appointment? Is there anybody else she can talk to? Does she have family? Does she have numbers for the crisis team? IAP - self refers. Mindful ness app.

Increasing flashbacks at night, related to her trauma

Difficulties concentrating hyper- vigilance and emotional numbing - does she feel like she can’t keep herself safe? Is she working late walking home in he dark?

Intrusive thoughts about ending her life feels exhausted and hopeless - not sleeping so over thinking?

Poor sleep and appitite and has withdrawn from social and academic commitments Signs of relapse - no energy. Is this why Mia is withdrawing from academic commitments.

Sertraline 100mg/ propranolol 40mg is linked to anxiety and self harm. - needs a medication review

Capacity act

Mental health

A-E assessments

Bloods - anemia

Refer back to phycological services or mental health

HADS - hospital anxiety and depression score - to assess the state or her anxiety

EMDR - NICE guidelines 1.6.18

CBT - NICE guidelines 1.6.16

NHS helpline

Samaritans

MIND

CDC - suicide prevention - 2024

https://www.england.nhs.uk/publication/the-five-year-

forward-view-for-mental-health/ - to give helps with

helping with mental health over 5 years.

https://www.gov.uk/government/publications/suicide-prevention-strategy-for-england-2023-to-2028/suicide-prevention-strategy-action-plan

Are her house mates at risk? As she may cause them danger due to flashbacks

Self neglect

WHO - An implementation guide for suicide prevention in countries - 2021

MIND - types of mental health problems - 2020