We thank Helen Stallman for her interest in our Article. It is worth highlighting that the high-risk paradigm has proven to be unsuccessful as an approach to mental health care. Our view is that care should be based on the patients' needs. In our Article, we concluded that individual factors have poor utility when evaluating the future risk of suicide at hospital presentation. We did not advocate a risk-based approach to the clinical care of patients who self-harm, but rather an approach whereby mental health practitioners should provide all patients presenting to hospital following self-harm with a thorough (bio)psychosocial assessment. This assessment—which includes enquiring about an individual's problems that contributed to their self-harm, mental health, risks of future self-harm, and the type of aftercare that would be most helpful—should lead to an individually tailored care plan to their specific needs. This is presented in the 2011 National Institute for Health and Care Excellence guidelines.

中文翻译：

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住院后自杀：全身治疗失败应成为重点，而不是危险因素–作者的回复

感谢Helen Stallman对我们的文章感兴趣。值得强调的是，高风险范例已被证明不能成功地用于精神保健。我们认为，护理应基于患者的需求。在我们的文章中，我们得出结论，在评估医院就诊时自杀的未来风险时，各个因素的效用不佳。我们不主张对自残患者进行临床治疗时应采用基于风险的方法，而应采用这种方法，精神卫生从业人员应为自残后就诊的所有患者提供全面的（生物）社会心理评估。这项评估-包括询问一个人的问题，这些问题会导致他们的自我伤害，心理健康，未来自我伤害的风险，以及最有帮助的善后服务类型-应制定针对其特定需求的个性化护理计划。这在《 2011年美国国家健康与护理卓越研究所指南》中有所介绍。