Self harm and suicide Flashcards
What phrase should never be used in describing a situation?
Attempted suicide
Removal of a high lethal index method of suicide results in a net increase in suicide. T/F
False it results in a net decrease, removing an easy method of killing yourself deters those who are not as driven.
List some high lethal index methods that have been removed from society.
Switch from coal gas ovens to North Sea gas
Addition of catalytic converters in cars
Describe the pattern between availability and use in relation to method of suicide.
The availability of a method correlates directly with its frequency as a mode of suicide.
e.g. guns present a biggest danger to their owners
Describe the neurobiology of someone with a past history of deliberate self harm.
Lower CSF 5-HIAA
Reduced binding of 5-Ht in ventral prefrontal cortex
Increased 5-HT1a receptors post synaptically
What does the neurological imaging of a patient with a past history of deliberate self harm show?
Reduced pre frontal activity
How should we consider self harm?
Not a cry for help as most cases of self harm go un reported.
Instead its actualising and physicalising their emotional distress
Describe the link between DSH and suicide.
It is a robust predictor, but percentage of those who go on to kill themselves is still small.
What are some motives behind suicide?
To die
To escape anguish or their situation
To influence others
To get help
What is important to remember when talking to a someone who wants to or has tried to commit suicide?
Asking questions doesn’t cause them to commit
What are some good questions to ask someone who wants to commit suicide or has tried to?
What are the things that keep you going?
What stopped you?
How close have you come before?
If I let you go now will you try again?
How can you bolster your patients self esteem and prove that they can do it?
That discussing with a complete stranger takes bravery and that any relief you feel from this conversation shows that further discussion down the line will help.
What should be discussed and arranged before you let a patient leave?
Create a safety plan such as a list of things they should do before the they try and commit suicide such as go to favourite coffee shop , listen to your favourite song or go to A and E.
Arrange for psychiatry counselling social work to follow up.
Manipulative patients
Use the threat of suicide to engineer a change in their surroundings they were otherwise unable to do.
Types of manipulative patients
Dependant clingers
Entitled demanders
Manipulative help rejectors
Self destructive deniers
