Suicide

Question 1

What to do about suicidal ideation

Answer 1

always ask
always take seriously
listen to verbal and nonverbal

Question 2

people who attempt or complete suicide often have….

Answer 2

poor critical thinking skills
troubled emotional lives
low threshold for emotional pain

Question 3

risk factors for youth suicide

Answer 3

lost parent to suicide
childhood maltreatment
problematic family relations
hx of bullying
family hx of suicide
socioeconomic problems
parental psychopathologic problems
peer problems
legal/discipline problems

Question 4

neurobiologic theory of suicide

Answer 4

decreased 5HT linked

biological response to stress

Question 5

genetic theory

Answer 5

family hx

Question 6

societal factors theory

Answer 6

no social support

Question 7

psychological factors theory

Answer 7

psychotic tendencies (command hallucinations)
hopelessness
helplessness
worthlessness

Question 8

Adolescents and young adults risk factors

Answer 8

strongest:  substance abuse, aggression, disruptive behaviors, depression, social isolation
frequent running away
frequent rage and problem with parents
family loss, instability, withdrawal
perception of failure
expression of suicide
difficulty dealing with sexual orientation
unplanned pregnancy

Question 9

older adult risk factors

Answer 9

social isolation
solitary living arrangements
widowhood
lack of financial resources
poor health
hopelessness
most visit their primary care dr within last month

Question 10

SAD PERSONS

Answer 10

S: sex--male (1)
A: age-- <19 or >45 yrs (1)
D: depression/hopelessness (2)
P: previous attempt/psych care (1)
E: excessive ETOH/drug use (1)
R: rational thinking loss (2)
S: separated, widowed, divorced (1)
O: organized plan/serious attempt (2)
N: no social support (1)
S: stated future intent (1)

0-5: may be safe
6-8: possible psych consult
>8: possible hospital admission

Question 11

behavioral cues

Answer 11

giving away prized possessions
farewell notes
making will
putting personal affairs in order
failing to sleep/fall asleep more than 1 night in a row
sudden or unexpected improvements in mood
neglecting personal hygiene

Question 12

lethality of plan

Answer 12

How detailed is the plan?
How lethal is the proposed plan?
How available is the method? (own gun)

Question 13

assessment of risk

Answer 13

ask
assess for precipitating event
assess risk factors
assess hx or family hx
intent, lethality, injury

Question 14

red flags suicide risk

Answer 14

sudden change from sad to happy

giving away possessions

Question 15

interventions during the crisis stage

Answer 15

safe environment
document pt activity
suicide precautions
construct verbal or written no-suicide contract
encourage pt to talk about feelings

Question 16

interventions after crisis period

Answer 16

place for pt to stay
remove weapons and pills
social support
crisis counseling
anxiolytics and antidepressants (1-3 day supply)

Question 17

communication

Answer 17

crisis is temporary
unbearable pain can be survived
help is available
not alone