Clin Med - Suicide Flashcards
State the percent of individuals who die by suicide who have visited their primary care physicians within a month of their death.
45%
Identify the two consistent psychological precursors to suicidal behavior.
- feelings of hopelessness
- inability to make positive changes in one’s life
Compare the suicide and homicide rates in Oklahoma and in the United States.
- suicide: Oklahoma=24.3%, USA=15.9%
- OK suicide rate 3x homicide rate
- US suicide rate 2x homicide rate
Identify which demographic group is at the highest risk of suicide.
White males > 85 years old
State the national rank of suicide as a cause of death in the United States.
10th leading cause of death (44,965 people)
State the leading suicide method.
61% Firearms: handguns > rifles > shotguns
Name the three domains in the Interpersonal Theory of Suicide that must overlap to create a strong risk for suicide.
- Thwarted Belongingness: feel isolated/like they don’t belong
- Perceived Burden
- Capability
Name the three leading circumstances associated with suicide in Oklahoma from 2012-2016.
- 44% –> 1+ diagnosed/treated mental health problem
- Depression > bipolar > anxiety > schizophrenia > PTSD - 34% –> intimate partner problem
- 31% –> current depressed mood
Identify the most common suicide circumstances in Oklahoma from 2012-2016.
- Physical health problem
- Substance abuse problem
- Alcohol problem
- Recent criminal legal problem
- Job problem
- Financial problem
Biopsychosocial risk factors for suicide
- mental disorders
- alcohol/substance use
- hopelessness
- impulse/aggressive tendencies
- history of trauma/abuse
- major physical illness
- previous suicide attempt
- family history of suicide
Environmental risk factors for suicide
- job/financial loss
- relational/social loss
- easy access to lethal means
- local clusters of suicide with contagious influence
Social risk factors for suicide
- lack of social support
- isolation
- stigma associated with help-seeking
- barriers to accessing healthcare/mental health/substance abuse
Cultural risk factors for suicide
- cultural/religious beliefs
- exposure to and influence of others who died of suicide
State protective factors for suicide.
- Effective clinical care for mental/physical/substance use
- Easy access to variety of clinical interventions/support
- Restricted access to highly lethal means of suicide
- Strong connections to family/community support
- Support through ongoing medical/mental healthcare relationships
- Skills in problem solving, conflict resolution and nonviolent handling
- Cultural/religious beliefs discouraging suicide and support self-preservation
Recognize the questions that may be asked when using the 2 Question Screen.
- Are you thinking of hurting yourself?
- Are you thinking of killing yourself?
State the meaning of the letters QPR in relation to suicide prevention.
Q - question
P - persuade
R - refer
Identify direct verbal clues that might be signs of a potential suicide attempt.
- I’ve decided to kill myself
- I wish I were dead
- I’m going to commit suicide
- I’m going to end it all
- If “something” happens, I’ll kill myself
Identify indirect verbal clues that might be signs of a potential suicide attempt.
- I’m tired of life
- What’s the point of going on
- My family would be better off without me
- Who cares if I’m dead anyway
- I can’t go on anymore
- I just want out
- I’m so tired of it all
- You would be better off without me
- I’m not the man/woman I used to be
- I’m calling it quits, living is useless
- Soon I won’t be around
Identify behavioral clues that might be signs of a potential suicide attempt.
- Relapse into drug/alcohol after period of recovery
- Purchasing gun
- Stockpiling pills
- Putting personal/business affairs in order
- Making/changing will
- Giving away money/prized possessions
- Suspicious behavior (going out at odd times, waving/kissing goodbye)
- Sudden interest/disinterest in church/religion
Identify situational clues that might be signs of a potential suicide attempt.
- Sudden rejection by loved one
- Recent move (esp. if unwanted)
- Death of spouse, child, friend (esp. if by suicide/accident)
- Terminal illness diagnosis
- Sudden unexpected loss of freedom
- Anticipated loss of financial security
- Loss of cherished counselor/therapist
Identify indirect questions that may be used in the QPR technique with a patient who may be at risk to die from suicide.
- Have you been unhappy lately?
- Have you been very unhappy lately?
- Have you been so very unhappy you wish you were dead?
- Do you ever wish you could go to sleep and never wake up?
- You know, when people are as upset as you seem to be, they sometimes wish they were dead. I’m wondering if you’re feeling that way too.
Identify direct questions that may be used in the QPR technique with a patient who may be at risk to die from suicide.
- Have you ever wanted to stop living?
- You look pretty miserable. Are you thinking of killing yourself?
- Are you thinking about suicide?
Name the most important skill that one must develop and use after asking indirect or direct questions to an individual who may be at risk to die from suicide.
*Listening
To become better at listening:
- Give your full attention
- DO NOT interrupt, speak only when the other person has finished
- DO NOT rush to judgement/condemnation
- Tame your own fear, focus on the other person
State the guidelines for an effective referral.
- best
- next best
- third best
- Best referrals: you personally make appointment at take person to mental health provider.
- Next best: personal agrees to see professional so you can follow up later and know they kept the appointment.
- Third best: getting person to agree to accept help, even if in the future, and providing them specific referral information.
