Suicide

Question 1

What is suicide ideation?

Answer 1

thinking about, considering,or planning for suicide

Question 2

What is suicide attempt?

Answer 2

A non-fatal self directed, potentially fatal and injurious behavior with any intent to die as a result of the behavior. A suicide attempt may or may not result in injury

Question 3

Define suicide

Answer 3

Death caused by self directed injurious behavior with any intent to die as a result of the behavior

Question 4

What is non-suicidal self directed violence?

Answer 4

“Behavior that is self-directed and deliberately results in injury or potential injury to oneself. There is no evidence, whether implicit or explicit, of suicidal intent”

Question 5

What is undetermined self-directed violence?

Answer 5

behavior that is self-directed and deliberately results in injury or the potential injury to oneself. Suicidal intent is unclear based upon the available evidence”

Question 6

What is proximal risk?

Answer 6

external circumstances believed to have played a role in precipitating self –directed violence”

Question 7

What is imminent risk?

Answer 7

potential that an individual will immediately engage in self-directed violence with suicidal intention upon completion of the clinical interaction”

Question 8

What are unacceptable terms related to suicide?

Answer 8

1. Completed Suicide: implies achieving a desired outcome
2. Failed attempt: judgmental
3. Nonfatal suicide: contradictory
4. Para-suicide: WHO current recommendation is non-suicidal self directed violence
5. Successful suicide: achieving a desired outcome
6. Suicide gesture, Manipulative Act and Suicide threat: pejorative, gives a value judgment

Question 9

What is egotistic type of suicide?

Answer 9

low social integration, sense of meaningless among individuals (“I don’t belong”)

Question 10

What is altruistic suicide?

Answer 10

person feels deeply committed to group norms and goals; see own life as unimportant, they die for a “cause”.

Question 11

What is anomic suicide?

Answer 11

Life seems aimless, breakdown of standards and norms (“There is no point/ there is no purpose”)

Question 12

What is fatalistic type of suicide?

Answer 12

the individual sees no hope of change. (“Things will never get better”)

Question 13

What are the suicide trends across the lifespan?

Answer 13

1. Per 100,000
A. Children ages 10-14 ---0.9 
B. Adolescents ages 15-19 ---6.9 
C. Young Adults ages 20-24 ---12.7
D. Adults age 65 and older the rate is 14.3

Question 14

What is the male to female suicide ratio?

Answer 14

Four times as many males as females die by suicide

Question 15

What is screening tool for suicide?

Answer 15

IS  PATH  WARM?
I- ideation  
S- substance abuse
P- purposelessness
A- anxiety
T- trapped
H-hopelessness
W- withdrawal
A-anger
R-recklessness
M-mood change

Question 16

What are warning signs for suicide?

Answer 16

1. Increased substance use
2. No reason for living/sense of purpose
3. Anxiety, agitation
4. Unable to sleep or sleeping all the time
5. Feeling like there is no way out/no other options
6. Giving away items/ tying up loose ends
7. Dramatic change from despair to peacefulness

Question 17

What are the risk factors for suicide?

Answer 17

1. Depression and other mental disorders
2. Prior suicide attempt
3. Family history of mental disorder or substance abuse
4. Family history of suicide
5. Family violence including physical or sexual abuse
6. Firearms in the home (method used in more than half of suicides)
7. Incarceration
8. Exposure to suicidal behavior of others such as family members, peers or media figures

Question 18

What are the suicide protective factors:personal reasons?

Answer 18

1. Resiliency
2. Social competency/ problem solving
3. Perception of social support from others
4. Positive expectations/optimism for the future

Question 19

What are the suicide protective factors:community resources/relationships?

Answer 19

1. Bonding or connectedness to family
2. Effective clinical treatment relationship
3. Cultural and religious beliefs that discourage suicide and support self preservation
4. Quality and access to social services and healthcare
5. Presence and involvement of caring social networks (social engagement)

Question 20

What is the evidence based assessment for suicide?

Answer 20

1. Columbia Suicide Severity Rating Scale (C-SSRS)
2. Demonstrated ability to predict suicide attempts in suicidal and non-suicidal individuals (predictive validity)
3. Mental health training is not required to administer
4. Reduction in unnecessary interventions/redirecting scarce resources within hospitals, schools and department of corrections

Question 21

What are the clinically effective treatments for suicide?

Answer 21

1. Cognitive therapy
2. Dialectical Behavior Therapy
3. Clozaril (Clozapine)

Question 22

How does cognitive therapy treat suicide pts?

Answer 22

addresses cognitive distortions and facilitates problem-solving. Reduced rates by 50% in 1 year follow up

Question 23

How does dialectical behavior therapy treat suicide pt?

Answer 23

Reduced attempts by half for those with borderline personality disorder in 2 year follow up

Question 24

How does clozaril (Clozapine) treat suicide pts?

Answer 24

approved by FDA for suicide prevention in Schizophrenia

Question 25

What are the barriers to effective suicide treatment?

Answer 25

1. provider discomfort and indifference
2. Focus on historical details (re-traumatization)
3. Lack of knowledge
4. Liability and fear of litigation
5. “I don’t have time”

Question 26

What are the principles for effective intervention?

Answer 26

1. Emotional CPR
   A. Informed by a number of best practice approaches including: trauma-informed care, crisis counseling, emotional intelligence, suicide prevention and cultural attunement.

Question 27

What does the C in emotional CPR stand for?

Answer 27

C = connecting

Question 28

What does the P in emotional CPR stand for?

Answer 28

emPowering

Question 29

What does the R stand for in emotional CPR?

Answer 29

Revitalizing