Suicide Flashcards
suicide
death caused by self-directed injurious behavior with intent to die as a result of the behavior
suicide attempt
*a non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior
*a suicide attempt might not result in injury
suicidal ideation
thinking about, considering, or planning suicide
non-suicidal self-injury
*the deliberate immediate destruction of one’s own body tissue (e.g. self-cutting, bruising, burning) in the absence of conscious suicidal intent
*excludes socially accepted practices such as tattooing and body piercing
suicide risk factors
*depression or other mental disorders
*substance-abuse disorder
*prior suicide attempt
*family hx of mental disorder or substance abuse
*family hx of suicide
*family violence, including physical/sexual abuse
*firearms in the home
*incarceration
*exposure to the suicidal behavior of others (family members, peers, media figures)
“low” suicide risk
*“passive” suicidal ideation
*NO plan
*NO intent or means
*agrees to safety plan
“moderate” suicide risk
*“active” suicidal ideation
*plan
*NO intent or means
*agrees to safety plan
“high” suicide risk
*“active” suicidal ideation
*plan
*intent or means
*does NOT agree to safety plan
assessment of suicide risk
*initial objectives: reflect, summarize, validate
*elicit the story primarily through open-ended questions with more specific data gathering as needed
*do not minimize the difficulty or jump into problem-solving mode too soon
what to do when someone is suicidal: “no-harm contract”
*generally REJECTED in clinical practice
*the term “contract” can feel coercive or controlling (risky for someone who may experience an extreme lack of control)
*lack of standard language or empirical basis
what to do when someone is suicidal: safety plan
*standard of care
*emphasis on patient safety as opposed to control
*often include:
-warning signs
-coping skills
-personal resources
-professional resources
-changes in environment
rationale for safety plans (in suicide risk pts)
*suicidal ideation can be long-lasting or wax and wane, but the window of time during which someone is actually capable of acting on suicidal thoughts is often brief
*reducing access to potentially lethal methods reduces risk of acting on SI during these times
*developing the safety plan is an act of empowerment in and of itself and provides behavioral alternatives to self-harm
