Flashcards in Quiz #2: Suicidal Behavior Deck (12)
Epidemiology of Suicide
-10th leading cause of death, outnumbering homicide
-Highest suicide rate for any group in the U.S. is among people older than 80 years
-3rd leading killer of young people
-Incidence varies among cultural groups
(More common among Whites than Blacks at all ages. Certain groups at higher risk, such as LGBTQ)
-Women attempt more than men but men are more successful
-Guns account for half of all suicides
Risk Factors for Suicide Include
-Past suicide attempts (strongest predictor!)
-Psychiatric diagnosis (mood disorders, substance abuse, schizophrenia, and anxiety disorders)
-Personality traits/disorders (Hostility, impulsivity, depression, and hopelessness)
-Psychosocial factors and physical illness
(Loss, lack of social supports, negative life events, and chronic physical illness)
-Genetic and Familial Variables (Family history of suicide)
-Biochemical (Low levels of serotonin (5-HT))
-Demographic factors (Males, persons who are unmarried, elderly, adolescent & young people, White race)
-Precipitating Stressors (any overwhelming stress)
Suicide Protective Factors Include
-Ability to cope w/ stress
-Access to care and medications
-Restricted access to highly lethal methods of suicide
-Skills in problem solving
-Cultural/religious beliefs against suicide
-Sense of hope
Suicidal verbal and nonverbal cues
1. Overt Statements (i.e “I wish I were dead”, “life isn’t’ worth living anymore”)
2. Covert Statements (i.e “It’s okay now. Soon everything will be fine.”, “Things will never work out.”, “Nothing feels good to me anymore and probably never will.”)
Suicide: Assessment - Specific Questions
-Have you ever felt that life was not worth living?
-Have you been thinking about death recently?
-Did you ever think about suicide?
-Have you ever attempted suicide?
-Do you have a plan for completing suicide?
-If so, what is your plan for suicide?
Asking direct questions about suicide
-Does NOT make the patient more prone to suicide!
-Most people want to talk about their depressed and/or suicidal thoughts, but are too scared/ashamed to seek out help.
Assessment - Lethality of Suicide Plan
-Evaluating suicide plan is extremely important in determining degree of suicidal risk
-People who have definite plans for the time, place, and means are at high risk
-**People who are psychotic are at high risk regardless of specificity of plan
Main elements that need to be considered when evaluating lethality of suicide plan
-Is there a specific plan with details?
-How lethal is the proposed method?
-Is there access to the planned method?
“High Risk” suicide plans include
-Staging car crash
“Low risk” suicide plans include
-Inhaling natural gas
Implementation for those at risk for suicide
1. Protection and safety (highest priority!): Adequate suicide assessment; safe environment of care; adequate and competent staff; adequate supervision; adequate medication management
2. Increasing self-esteem: Reinforce reasons for living and promote patient’s strengths
3. Regulating Emotions and Behaviors: Encourage socialization; Physical activity; Relaxation; Process feelings
4. Social Support
5. Patient Education: Medication regimens; handling future crises
6. Suicide Prevention: Telephone services; Find support groups