Suicideology Flashcards
(21 cards)
1
Q
- ___ people per day commit suicide (2014)
- ___th leading cause of death
- ___% suffer from a diagnosable mental illness
A
- 117
- 10th, more than car accidents
- 90%, mostly depression
2
Q
- Massachusetts is the ____th ranked state for suicides (2014)
- Massachusetts suicide rate is (increasing or decreasing).
A
- 48th
2. increasing by about 3.6%
3
Q
Suicide Treatment Best Practices:
A
- Understanding Suicide
- Risk and Protective Factors
- Managing Reactions
- Therapeutic Empathy
- Eliciting the Narrative
- Measures and Tools
- Assigning Level of Risk
- Crisis Intervention
- Treatment Overview
- Standard of Care
- Postvention, grief, loss
- Hope and self-care
4
Q
- Number who think about suicide
- Number who plan a suicide
- Number who attempt suicide
- Number of suicide deaths
(2013)
A
- 9,000,000
- 2,700,000
- 1,300,000
- ~ 38,000
* HUGE difference between attempts and deaths
5
Q
Language of Suicide
- crime, a sin
- successful, failure
- suicide gesture
A
- you commit crimes, sins, and suicide
- a successful suicide attempt = death, a failed attempt = live –> maybe we shouldn’t equate failure with living
- self-injury without attempting to kill yourself, unclear what this term means, speaker didn’t like it
6
Q
Venn Diagram
- Those who desire suicide
- Intersection
- Other Circle
A
- perceived burdensomeness, thwarted belongingness
- Those who attempt suicide
- those who are capable of suicide
- people have a very strong innate survival instinct - so what does it take for someone to be able to override that?
- foot in the door phenomenon -> you get used to thinking about suicide, and then you get used to the planning, and over months the actual suicide doesn’t seem like so much
7
Q
Risk Categories
A
Those we can't change: --- Previous Attempts --- Family History --- Medical Factors --- Demographic Factors Those we can change: --- Cognitive Style --- Access to means to commit suicide --- Psychosocial factors (social support) --- Clinical factors --- Substance abuse/addiction
8
Q
Means Reduction: states with high and low percent of gun ownership
A
- States with high gun ownership have way more fire-arm suicides, but high and low states have about the same number of non-fire-arm suicides --> people do not find another way High Gun Ownership States: -- population: 39 million -- 47% gun ownership -- 9,749 fire-arm suicides -- 5,060 non-fire-arm suicides Low Gun Ownership States: -- population: 40 million -- 15% gun ownership -- 2,606 fire-arm suicides -- 5,446 non-fire-arm suicides
9
Q
How does a suicide occur?
1 –> 2 –> 3 –> 4a –> 5a
1 –> 2 –> 3 –> 4b –> 5b
A
- Underlying vulnerability
- Stress event
- may be caused by underlying vulnerability (1. depression, 2. depressive episode) - Acute Mood Change
- anxiety, dread, hopelessness, anger
4a. Inhibition
- social taboo, slowed mental state, social support
4b. Facilitation
- available means, agitation
5a. Survival - no suicide attempt
5b. Suicide
10
Q
Warning Signs (Acronym)
A
- IS PATH WARM?
- Ideation, Substance use
- Purposelessness, Anxiety, Trapped, Hopelessness
- Withdrawal, Anger, Recklessness, Mood
11
Q
Youth
A
- 2nd highest cause of death
- Impulsivity
- Influence of media
- LGBTQ
- Attention-seeking
- – if they need attention, give it!
12
Q
Protective Factors
Assessment: Reasons for Living Inventory
A
- Availability of Physical and mental health care
- Restrictions on lethal means of suicide
- Safe and supportive school and community environments
- Sources of continued care after psychiatric hospitalization
- Connectedness to individuals, family , community, and social institutions
- Supportive relationships with health care providers
- Coping and problem solving skills
- Reasons for living (e.g. children in the home)
- Moral objections to suicide
13
Q
Managing your reactions
A
- Therapist reacts emotionally to hearing client’s suicidal
- fear, anxiety, anger
- Emotional reactions lead to mistakes
14
Q
Eliciting the Narrative: what not to say
A
- you are not thinking of committing suicide, are you?
- be smart when choosing your words
15
Q
How to Ask About Ideation
A
Ask about onset, duration, frequency, active/passive, lethality, underlying intent, triggering events, what intensifies the thoughts, what distracts the thoughts, association with states of intoxication, understanding of consequences.
- Ideation/plan is a coping strategy
- If depressive symptoms are severe, don’t accept denial at face value
- – ask why they are not suicidal (reasons for living)
16
Q
How to Ask about Intent
A
Assess for evidence of wish to die, means to kill him/herself, and understanding of the probable consequences of his/her actions.
- always ask twice
- understanding intent is critical
17
Q
How to Ask about Behavior
A
Assess if the individual has engaged in any actual behavior of preparation for engaging in self-directed violence.
18
Q
Validity Techniques
A
- Gentle assumption - what other ways have you thought about to kill yourself?
- Normalization - sometimes when people feel depressed, they think about suicide, have you?
- Symptom Amplification - how many times a day do you think about suicide, 50? 100 times?
- Shame Attenuation - I know you are morally opposed, but has it ever crossed your mind just fleetingly?, non-judgemental
- Behavioral Incident - What did you do then?
19
Q
Crisis Intervention Techniques
A
- Restricting Access
- Decreasing Isolation
- Decreasing Agitation
- Structuring Treatment
- Providing Hope and Reality Testing
20
Q
No-Suicide Contract
A
- promise me you won’t kill yourself
- fall sense of security for clinician
- not proven to be effective
21
Q
Safety Plan
A
- list of coping strategies to use when client has suicidal urges
- written in client’s own words
- use lower down steps if higher ones don’t work
Step 1. Recognizing warning signs of a crisis (automatic negative thoughts, crying, isolation)
2.Employing internal coping strategies without needing to contact another person.
3.Socializing with family members or others who may offer support as well as distraction from the crisis.
4.Contacting family members or friends who may help to resolve a crisis.
5.Contacting mental health professionals or agencies.
6.Reducing the potential use of lethal means. (secure place to keep gun, throw out unnecessary meds)
Additional question: “The one thing that is most important to me and worth living for is:___________________”
