What do you think when you notice someone has obvious scars from a suicide attempt?

As stated in the OP my main question is to medical professionals but anyone can participate; jewelers, massage therapists, manicurists; hell, anyone who might encounter it on a regular basis. I assume you know to what I’m referring but if not, I mean the unsightly scars of someone who once tried to slit their wrist (s)
When I say “deal” I guess I just mean what, if anything goes through your mind? Do you even notice, and if so, do you . . . think things? Do you mention to your colleagues in private? Do you look at the patient differently (I’m talking about if they’re there for a procedure that is not mental health related)?

If , during an assessment, I see something that looks like cutting scars, wrist scars or in one memorable case, some unusual looking abdominal scars, I ask about them. It is part of my responsibility to do so. I will also ask about suicidal or homicidal thoughts, actions or plans. I’m not there to judge, I am there to help.

Cub Mistress, RN

Thanks, CMiss. What if they are clearly old / long since healed?


I would like to know about your scars’ origins. I mean, unless I’m seeing you in the flu shot clinic or something, and you’ll never be my patient again after the next 5 minutes. If I’m going to be responsible for your nursing care, that’s comprehensive nursing care you’re going to be getting. Things that you may think aren’t important may be important to a nurse.

I’m never going to assume your scars are from self-harm or a suicide attempt. If they’re actually from a horrific car accident 2 years ago that is the reason you take 8 vicodin a day, I need to know that before the doctor and I decide on your morphine dose.

People tend to forget to tell us things. Like that they’re on 8 vicodin a day. Sometimes you find out the important things by asking about the unimportant things.

I do a lot of initial physical exams on convicted felons. I ask about scars when I see them. If they say the scar is from a past suicide attempt, I check their Mental Health designation (determined at intake into prison by a psych social worker) to see if they’re considered a risk and slotted to see a psychiatrist or Ph.D. psychologist or not. Depending on what I see, I may ask if they’re having thoughts about harming themselves or others. At need, I can do urgent referrals to the mental health folks.

Then I proceed with taking care of their current physical health needs.

Eep; I have perpetrated a thread topic fail. What I really mean- I mistakenly mentioned med personnel because it was my trip to the dentist that brought it to mind- is what do any of you think when you see what can be construed as suicide scars on someone? Mods, please edit my title ( if you understand what I really mean and you think it’s worthy).

Even if they are old. The abdominal scars I mentioned upthread were the result of attempted suicide in the Vietnam era. The patient told me the story, then admitted he had only told 2 other people the story, ever.

Did you see those scars on any of the dental personnel?

In medicine you can’t be coy – people’s lives are at stake. So you just ask them straight up about the scars. It can seem awkward when you’re new to the field, but after you’ve seen the pros do it a few times you realize it’s just a routine part of the job.
I once encountered a patient with scars on her knuckles – from her own teeth. She had been jamming her fingers down her throat to induce vomiting.

Not sure how to notify the mods to change the thread title - what it should really say is a more broad title "what do you think when you notice visible scars from (what you assume is) a previous suicide attempt?

I mentioned med pros because
a) as I said, it came to me because I visited the dentist today
b) they’re the ones most likely to be looking at one’s wrists

But I don’t really mean “deal” in a clinical sense. I guess I really mean, what do you (whoever *you *are) think when you encounter such a thing?

I think, “boy, that looks like it might be from cutting…”

My older kid and his friends were into cutting. None of them ever attempted suicide. I’m liklier to think cutting than suicide.

Best way to notify a Mod is to click on the little red triangle in the upper right of any of the posts in this thread. It will give you a little popup box where you can type your request to the mods.

Thanks, WhyNot. You’d think I’d know after all this time. Anyway, off to put forth the question I’m really trying to ask . . .

Do you have visible scars on your wrists, and you’re looking for reassurance that medical professionals aren’t judging you when they see that?

If so, I’d say that most people in the medical profession know and understand the level of emotional pain that a suicidal person experiences, and are more likely than anyone else to feel empathy for someone that carries those scars. Not that there aren’t judgers, I’m sure, but probably less likely.

Never mind. Redundant post.

I try not to make any assumptions. I have a co-worker who accidentally put her hand through a window as a kid. The resulting scars on her wrist and arm (she had surgery to have tendons repaired) can be and often have been mistaken for a past suicide attempt. My old self-harm scars, on the other hand, look like I put my hand through a window.

As someone who has had a scar like that since i was a kid… My right wrist has a scar that wraps around almost to the top of either side of my wrist, and I honestly can’t remember anyone ever asking or saying anything about it. I never really thought about it, but now it’s kind of surprising nobody has ever said anything. hmmm

I know just one wrist would be a lot different than both… WOOKINPANUB Just try and not let it bother you what they think… and I know some will disagree, but my feeling is, it’s none of their damn business unless you want to make their business! IMHO

FYI, got my scar When I was like 12, I was walking home from the local dairy carrying a bottle of milk, and I tripped over a section of sidewalk that was raised up a couple of inches, from a tree root, and when I fell the bottle broke… Got over like 40 stitches .

All the best to you WOOKINPANUB !

It has been taken care of.

I think to myself, “it looks like that person has tried to commit suicide. I wonder why.” Then I move on.

I once dropped in on a friend. Someone else answered the door, and I looked over to where she was sitting with her boyfriend. He wrists were both bandaged.

“Someone must have told you,” she said. “Your eyes went straight to my wrists.”

No one had. I had no idea that she’d attempted suicide, but the bandages were impossible to miss, or to interpret.

What did I think? That I really had no idea that she had been on the edge, followed by the thought that this was a Cry For Help (Which I assumed because the attempt was unsuccessful and seemed relatively easily cared for).

I offered to help and asked if there was anything I could do, but she was in good hands and had a roomful of people already.

A friend of mine did cut herself when she was depressed, years ago. Not suicide, but automutilation, quite different. She still wears long sleeves to hide the scars, even when it is hot.

When I see them, i usually think: “Man, she must have felt worse back then, then she let on”. And I feel slightly guilty, and also a tiny bit glad that we were not that close at the time, because it is hard to help cutting behavior.

So it is a bit awkward, mostly for me ( she’s used to it) and then we move on.