Suicide

In 2012, Suicide: ______ leading cause of death >38,364 completed suicides _____ leading casue of death in 15 to 24 year olds Highest risk age group ______ 1 in 5 had contact with a mental health provider 45% had contact with PCP a month prior

10th third 65 years and older

IN ASSISTED SUICIDE, you must have ____ sign off saying they are terminal

2 physicians

There is one suicide for every ____ attempted suicides

25

Religion, role of the extended family

African Americans

What are the protective, cultural factors?

African Americans Hispanic Americans Asian Americans

Adherence to cultural beliefs that tend to emphasize interdependence between the individual and society Suicide may be preferable to shame

Asian Americans

. Which of the following is a misconception about suicide? A) Eight out of ten individuals who commit suicide give warnings about their intentions. B) Most suicidal individuals are very ambivalent about their feelings about suicide. C) Most individuals commit suicide by taking an overdose of drugs. D) Initial mood improvement can precipitate suicide.

C - most individuals commit suicide by taking an overdose of drugs Gunshot wounds are the leading cause of death among suicide

The nurse is caring for an actively suicidal client on the psychiatric unit. What is the nurse's priority intervention? A) Discuss strategies for the management of anxiety, anger, and frustration. B) Provide opportunities for increasing the client's self-worth, morale, and control. C) Place client on suicide precautions with one-to-one observation. D) Explore experiences that affirm self-worth and self-efficacy.

C - place the client on suicide percautions with one to one observation

Develop rapport Avoid note-taking Provide eye contact How do you ask?

Communication techniques

"It's okay, now. Soon everything will be fine." "Things will never work out." "I won't be a problem much longer." "Nothing feels good to me anymore and probably never will." "How can I give my body to medical science?"

Covert statements

A client, with a history of a suicide attempt, has been discharged and is being followed in an outpatient clinic. At this time, which is the most appropriate nursing intervention for this client? A) Provide the client with a safe and structured environment. B) Isolate the client from all stressful situations that may precipitate a suicide attempt. C) Observe the client continuously to prevent self-harm. D) Assist the client to develop more effective coping mechanisms.

D

Separate from the mainstream of society. EX: don't feel like they belong

Egoistic

Strategies for the immediate crisis

Encourage them to talk & share memories Discuss family dynamics Listen Recognize individual grieving patterns Discuss coping strategies Identify supportive resources

Take any hint of suicide seriously Do not keep secrets Be a good listener Let them know they are important Express concern Get rid of firearms Get them help Do not judge

Family education

Using a gun Jumping off a high place Hanging oneself Poisoning with carbon monoxide Staging a car crash

Hard methods of suicide

Roman Catholic religion and importance of extended family

Hispanic Americans

Sense of guilt Anger, resentment Helplessness, despair "If only..." Confusion Inner injury Strained relationships Vulnerable to illness

Immediate crisis

Should not be left alone Establish a "no-suicide contract" Enlist help of family & friends Daily contact Be direct Use problem solving approach/Control Antidepressants

Interventions with Out patient

Suicide occurs more frequently among those with:

Major depression Bipolar Schizophrenia Alcohol/substance abuse borderline and antisocial personality disorders panic disorder

People who talk about it don't do it You cannot prevent it from happening Improvement after depression means the risk is over It is just manipulation

Myths of suicide

"I am going to kill myself." "Life isn't worth living anymore." "I wish I were dead." "Everyone would be better off if I died."

Overt statements

How do you analyze the suicidal crisis?

Precipitating stressors Relevant history life-stage issues past psychiatric/medical history coping strategies

What are occupations with the highest risk of suicide?

Professionals with change in status Physicians, architects, engineers, lawyers, nursing and social work

Anger turned inward Hopelessness Desperation and guilt History of aggression and violence Shame and humiliation Developmental stressors

Psychological theories

What are types of nursing diagnosis?

Risk for suicide Hopelessness Ineffective coping Powerlessness Social isolation

Slashing one's wrists Inhaling natural gas Ingesting pills

Soft methods

Patient safety plan

What are your warning signs? What can you do to de-esculate? What places/Social settings can you go to? Who can you call to ask for help? How can you make your environment safe? Find out if there are weapons in the home

What are primary levels of intervention?

activities that provide support, information, and education to prevent suicide

Nonsuicidal self-injury = parasuicide Prevalence: 13-20% _____; 10-15 y/o, peaking late teans Comorbidity: depression, non-heterosexual orientation, BPD Etiology: Biological factors _____ Cultural factors _____ Societal factors_____

adolescents monoamines nothing significant social media sites

Excessively integrated into a group. EX: cult

altruistic suicide

response to change fear of loss of support

anomic suicide

Risk factors of suicide: Religion _____ Family hx ______ Other ______

decreased rates higher risk gay men and lesbians

______ attempt suicide less often but have a higher completion rate because their methods are more lethal

elderly

suicides outnumber homicides by 3:2 Suicide by ____ is the most common method for men and _____ is most common for women

firearm poisoning

_____ are the most commonly used suicide method in youth

firearms

Risk factors of suicide: Age _____ Gender ______ Ethnicity Marital status _____

increases with age; adolescents also men 4x more often than women white males 2 out of 3 suicides sing, divorce, widowed

Most adolescent suicide attempts are precipitated by _____

interpersonal conflicts

Tertiary levels of intervention?

interventions with the family and friends of a person who has committed suicide to reduce the traumatic aftereffects

Biological theories: Suicidal behavior _____ in families Gene variants Low levels of ____ may be a factor _____ is considered a factor in 11% to 51% of suicides Low _____ levels in post suicidal autopsies

runs serotonin Physical illness cholesterol

A significant public health problm in the US. A human life ends about every _____ minutes

suicide 14 minutes

Secondary levels of intervention

treatment of the actual suicidal crisis