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PSYCH > Suicide > Flashcards

Suicide Flashcards

1
Q

SI

A

all encompassing term for thoughts of death, wish to die, plans

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2
Q

Suicidal behavior

A

acts associated with intent like collecting means

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3
Q

Suicidal attempt

A

engaging in possible injurious bx with intent of death

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4
Q

Interrupted self-directed by other

A

another person stops them at any stage in the process or plan

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5
Q

Interrupted self-directed by self

A

they stop themselves

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6
Q

death by suicide

A

intent to die with death be self-injurious bx

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7
Q

suicide survivors

A

includes circl of ppl around one who died

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8
Q

postvention

A

mental care to survivor or circle of ppl
- get support, understanding, referrals

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9
Q

Warning signs

A

ind or group of bx or emo cues that may indicate contemplation or immediate risk for suicide

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10
Q

Cluster suicides

A

inc incidence of suicides when stories of suicide increases, stories are repeated, front page or beginning of broadcast, well-known person or dramatic headline
- occur closer in space and time than would be normally expected

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11
Q

DSM-5 suicide bx

A
  • does not include SI or preparatory acts for suicide
  • attempt w/i last 24M
  • cannot occur in delirium, political or religious objective, not NSSI
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12
Q

2016 Joint commission sentinel event alert 56

A

S major prob w/i hospitals

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13
Q

2019 Ntl pt safety goal

A

ID high risk goal but did not see major improvements w/i this
- est screenings, enviro risk assessment, documentation

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14
Q

Suicide prevention

A
  • know risk and warning
  • screen and ask others
  • ID protective fx, make safety plan, dec access to lethal means
  • give ind resources for s prevention
  • make comm based sys to respond to S risk
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15
Q

Ind risk factors for S

A

previous attempt
hx dep or other mental illness, alc or SUD, phys health, chronic ill, criminal/legal prob, job/financial prob, feel hopeless, current or prior hx adverse childhood experiences

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16
Q

Relationship risk fx

A

fam/loved one with hx S, lose relx, high conflict or violence, social iso

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17
Q

Community risk for suicide

A

clusters, lose resources, stress of acculturation, comm violence, historical trauma, discrimination

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18
Q

Societal risk factors

A

stigma, easy access to lethal means

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19
Q

Warning signs of S

A
  • feel hopeless, burden
  • preoccupied with death
  • inc sub use esp alc
  • anger, irritable, resentment
  • iso, w/d from fam/friends
  • looking for lethal means of access
  • mood swings
  • inc anx
  • give away possessions
  • sudden uplifting mood
  • sleep inc or dec
20
Q

Protective fx for S

A
  • ind - good coping, reasons for living, strong cultural ID
  • relx - strong connection
  • comm - feel connected, availability of good hc and behavioral care
  • societal - strong sense of cultural ID, cultural, religious, moral objective to S
21
Q

C-SSRS

A
  • assesses risk and protective fx
  • need protocol for screen pos if using this tool
  • know documentation for this
  • acquires risk level if SI is detected and reassess regularly
22
Q

Will most pt answer honestly is directly asked?

A

YES
and won’t inc risk of S

23
Q

Benefit of screening everyone for S

A

decreases stigma

24
Q

Stanley-Brown safety plan intervention

A
  • plan for how to get help, how to make environment safe, what makes life worth living
  • if pt get all the way thru plan, go to ED
  • better than “no S contract”—not used
25
Q

overt cues of S

A

i want to die, life not worth living

26
Q

covert cues of S

A

its ok, all will be good soon, nothing good anymore and can’t wait to change

27
Q

S assessment

A
  • know risk and protective
  • ask directly–how often have thoughts, have attempted?
  • verbal and nonverbal
  • assessment of lethality of plan
  • self-assessment
28
Q

Highest risk for S

A

Definite time, place, and plan

29
Q

Envrio safety for S

A
  • search pt and assess belonging for harmful objects
  • safe gown, no strings, perfume bottles, mirros, meds, lock window, low bed
  • keep extra stuff out
  • door open, no private room
  • lock doors to non-pt area or empty pt room
  • monitor gifts for harm objects
30
Q

Safety management for S

A
  • reassess risk if condx changes
  • safety plan intervention for all pt with IDed risk
  • ID and mitigation of enviro safety concerns on all pt care units
  • may need HCP sitter order
  • great hand off comm
  • safety rounds
  • means management in facility and before d/c
31
Q

Pt observation

A
  • provider decides obs level
  • nurses can escalate then get order
  • can dec per MD/APRN order
  • acute care 1:1 with staff
32
Q

NC for S

A
  • room close to nurse station and round
  • watch med ingestion for cheeking
  • teach coping
  • access firearms or self-harm methods
  • give comm resources and 988 at d/c
  • brief, freq intx
  • fight stigma
33
Q

NSSI

A

deliberate and direct attempts to inflict painful injuries to body surface w/o intent to die
- cuts, burns, scratch, bite, hit, pick, interfere with wound healing

34
Q

Where does NSSI often occur

A

Thighs and dorsal forearm

35
Q

Why is NSSI done

A

desire for relief from neg thoughts, feelings
- punishment from “bad deeds” often poor social interactions
- intent to alleviate psychic pain and numb, suffer from poor interpersonal
- short euphoria

36
Q

NSSI DSM-5

A

A. Occur at least 5d in last year to…
- relieve neg thought and feeling
- resolve interpersonal probs
- induce pos feeling state
B. Must precede by neg feels, conflict with others, preoccupation with bx
C. Behavior not socially sanctioned (pierce, tattoo, cultural/religious rituals)
D. cause signif distress or interfere with functioning
E. should not occur solely in context of other mental dx

37
Q

Do ppl with NSSI often seek help

A

Most don’t

38
Q

NSSI at risk pops

A

fem, esp before age 29

39
Q

NSSI comorbidity

A

dep/anx, SUD, ED, BPD

40
Q

Biological risk fx for NSSI

A

altered 5-ht, dp, nor

41
Q

cognitive risk fx for NSSI

A

self-punishment, positive reinforcement

42
Q

Enviro risk fx for NSSI

A

cultural diff

43
Q

Societal risk fx for NSSI

A

social phenomenon (peers engage)

44
Q

s/s NSSI

A

scars, fresh cut, bruise, broken bones, shar objects on hand, long clothes in hot weather, freq accidents, lots time alone, interpersonal struggle, question ID, behavioral instability, hopeless, helpless, impulsive

45
Q

NSSI NC and actions

A
  • therapeutic relationship with fam or friend, counselor
  • care for wound/injury
  • psychotherapeutic intervention like healthy coping w/o dependence on others
  • CBT, DBT, group therapy
  • psychopharm
  • self-harm scale
46
Q

Are NSSI ppl likely to show up in the ED?

A

No

47
Q
A

PSYCH (9 decks)

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