Suicide and Self-Harm

Question 1

How many people die every year from suicide

Answer 1

800,000

Question 2

What is the proper term for attempted suicide

Answer 2

Non-fatal deliberate self harm

Question 3

Which sex is most likely to commit suicide

Answer 3

Men

Question 4

Which countries have a higher death toll from suicide

Answer 4

Low and middle income countries

Often peaks earlier

Question 5

What are the most common methods of suicide in Scotland

Answer 5

Hanging - men

Poisoning - women

Question 6

When did suicide rates drop and why

Answer 6

Greatest dip in suicide rates in WW1, WW2 and 60s
WW due to greatest feeling of cohesion within society
Change in 60s due to change from toxic coal gas to north sea gas- restricting the lethality of sticking your head in the oven

Question 7

Which sex favours violent methods of suicide

Answer 7

Men
More likely to hang themselves
Women favour non-violent means like overdosing

Question 8

Which social classes have higher rates of suicide

Answer 8

More deprived groups

Also more common in urban areas

Question 9

Which season has the greatest number of suicides

Answer 9

Spring

Lowest incidence is in autumn

Question 10

Marriage is associated with higher suicide rates - true or false

Answer 10

False
Marriage has the lowest suicide rate
More likely if single, separated or widowed

Question 11

Which professions have the highest suicide rates

Answer 11

Dentists, Doctors, Farmers, construction workers, unskilled labourer’s
This is because they have access to means

Question 12

Most suicides have mental health issues at their time of death - true or false

Answer 12

True

Around 90% will be mentally ill at the time

Question 13

Which adverse effects can lead to suicide

Answer 13

Childhood abuse

Particularly sexual assault

Question 14

Media reporting of suicide can affect the incidence - true or false

Answer 14

True
If media reporting specifies the details or particular difficulties the person was having the rates increase
Get clusters of suicides

Question 15

Is self harm more common than suicide

Answer 15

Yes

10:1 ratio

Question 16

Which group has the highest incidence of self harm

Answer 16

Young women

Females have a higher rate

Question 17

How is cholesterol associated with suicide and self harm

Answer 17

Low cholesterol associated with increased self harm and suicide
Has a role associated with 5-HT (serotonin)

Question 18

what is the biggest risk factor for suicide

Answer 18

History of deliberate self harm

Around 40% of suicides have a history of self harm

Question 19

Which factors are associated with increased suicide risk

Answer 19

Age under 20 or over 44 
Male
Unemployed
Single, separated or divorced
Isolated or living alone
Poor health - chronic or severe physical illness
Major psychiatric illness - including history of depression 
Psychosis - active 
Drug or alcohol abuse 
Violent DSH
Active and organised plan
Previous suicide attempt

Question 20

Why do people deliberately self harm

Answer 20

To die
To escape anguish - get relief from emotion 
To feel something - get rid of numbness 
To escape a situation
To display desperation
To influence others - get their support
To get help

Question 21

What is the definition of deliberate self harm

Answer 21

Any self inflicted injury

e.g. self-poisoning, cutting, burning etc.

Question 22

What is the most common type of deliberate self harm

Answer 22

Self-poisoning

Then self-inflicted injuries

Question 23

Which factors are associated with deliberate self harm

Answer 23

Female
Younger
Chronic social and family problems
May have psych illness or personality disorder
Alcohol with episode
Past DSH
Impulsive

Question 24

What are the screening questions for assessment of deliberate self harm

Answer 24

PATHOS

• Have you had Problems for longer than 1 month?
• Were you Alone in the house when you overdosed?
• ‘Did you plan the overdose for more than Three hours?
• Are you feeling Hopeless about the future – that things will not get much better?
• Were you feeling Sad for most of the time before the overdose

Question 25

List red flags for active suicide risk

Answer 25

``` Marked hopelessness - "I am a burden" Continued intent Well formed plans Giving away possessions Social isolation or no support Chronic pain or physical illness A sense of feeling trapped in a situation with no other escape ```

Question 26

List predisposing factors for suicide

Answer 26

``` Adverse childhood experiences - abuse Social deprivation Family history of suicide Previous suicide attempts History of mental disorders Alcohol and drug misuse Social alienation/bullying Impulsive or aggressive tendencies Loss Physical illness Easy access to lethal means ```

Question 27

List precipitating factors for suicide

Answer 27

``` Bullying Recent discharge from psych hospital Changes in physical health Relationship difficulties Unemployment/ poor school attainment Loss Depressed mood/ worsening of mental health Exposure to suicide Exposure to stressful life events ```

Question 28

List perpetuating/maintaining factors for suicide

Answer 28

``` Lack of support or poor social network School pressure Stigma Degree of planning Access to means Psychological factors such as hopelessness Drugs/alcohol or other unhelpful coping Intensity of the thought ```

Question 29

List some protective factors for suicide

Answer 29

Effective clinical care - physical and mental and substance misuse Ongoing care and supportive relationships Supportive network of family and friends Good self-esteem and resilience Cultural and religious beliefs that discourage suicide Engaging in enjoyable activity