ICL 9.6: Suicide

Question 1

what rank is suicide in causes of death?

Answer 1

2nd leading cause of death for ages 15-34

it’s now also the 2nd leading cause of death for youth ages 10-14

unintentional injury is #1 for both age groups

Question 2

what is the risk trifecta for suicide?

Answer 2

1. ideation
2. plan
3. intent

Question 3

what is suicidal ideation?

Answer 3

the patients thoughts about suicide or about killing themselves – this is the first thing you assess when looking at suicidal risk

have you thought about killing yourself? have you thought it would be better if you weren’t here? have you thoughts about falling asleep and not waking up again? –> can be more passive or active thoughts like i wish i could go to sleep forever vs i want to die/i don’t want to live

you also need to asses if these are past or current thoughts, how often they have those thoughts, and for how long they’ve had these thoughts

Question 4

what is a suicidal plan?

Answer 4

have you thought about how you would kill yourself?

do they have access to the supplies to carry out the plan?

have they moved their body through space and time in regards to practicing this plan?

ex. firearms, wrist cutting, overdose, hanging, etc.

Question 5

what is suicidal intent?

Answer 5

do you really want to die?

have they started giving possessions away? are they googling suicide on the internet? have they talked to their friends or social media about doing it?

Question 6

what are the risk factors for suicide?

Answer 6

SADPERSONS

Ⓢex: male

Ⓐge: under 25 or over 65

Ⓓepression

Ⓟrevious attempts**

Ⓔthanol/drug use

Ⓡational thinking loss (psychosis)

Ⓢickness (Chronic illness/medical conditions)

Ⓞrganized plan

Ⓝo spouse/other support

Ⓢtated future intent

access to guns and history of family suicide are also huge risk factors

Question 7

what are the protective factors against suicide?

Answer 7

1. married/children
2. pets/hobbies
3. cognitive flexibility
4. family/friends
5. religion/spirituality
6. future goals
7. meaningful responsibilities

what has kept patients from killing themselves? especially in patients who actually have a plan already

Question 8

what do you do after you assess a patient’s suicide risk?

Answer 8

can we safely send this patient home?

are they a serious and imminent danger to themselves?

for people that have some suicidal ideation but have a lot of protective factors you can refer them to the national suicide prevention hotline, online crisis chat or crisis text help! so you send them home but with resources!

voluntary hospitalization or involuntary hospitalization (pink slip) if needed is for people you don’t feel you can send home because their risk factors out-weigh their protective factors