Suicide

Question 1

Basic Information - Suicide

Answer 1

• Primary psychiatric emergency

- Almost always associated with mental illness

Question 2

Epidemiology

Answer 2

• 10th leading cause of death
• Most common method: Hanging
• NJ lowest Rate
• Montana Highest overall
• WY highest for men
• AK and IDAHO highest for women
• Golden Gate - primary site in world

Question 3

Risk Factors

Answer 3

Gender

• Male to Female (4:1 completed): means of suicide may explain (men use firearms and hanging/jumping; women poison/overdose)
• Female to Male (3:1 thoughts/behaviors)

Age

• Increases with age
• Peak men after 45, women 55
• 3rd leading cause of death 15-24 yr olds

Marital Status

• single never married increased risk
• marriage decreases risk
• divorce increases risk

Occupation - work is protective

Physical Health: 1/3 of all people who commit suicide have had medical attention in previous 6 months

Mental Illness

• 95% of those who commit suicide have dx mental illness
• 80% depression
• 10% schizophrenia
• 5% dementia or delirium
• 25% comorbid alcohol dependence

Genetic and previous suicidal behavior

Question 4

Protective Factors

Answer 4

• family and community support
• Treatment
• Restricted access of lethal means
• cultural and religious beliefs
• coping mechanisms
• marriage
• employment

Question 5

Assessment

Answer 5

• Ideation
• Intent
• Plan
• Means
• Previous suicide attempts
• Substance abuse/use
• Verbal/Behavioral clues

Question 6

Nursing Interventions

Answer 6

• Create a safe environment
• Determine level of supervision needed
• Assess for suicidal behavior/ideation
• Develop a safety plan with client
• Develop and maintain a collaborative therapeutic relationship with patient
• Intershift and interprofessional communication

Question 7

Safety Planning/Crisis plans

Answer 7

• Safety plans have replaced “No harm” contracts in suicide prevention and treatment
• Commitment for what a person will do rather than what they will not do
• List of coping strategies and sources of support:
  
  • Step 1: help patient be aware of their own triggers
  • Step 2: help identify and practice coping strategies
  • Step 3: assess access to lethal means