Suicide Flashcards
What to do about suicidal ideation
always ask
always take seriously
listen to verbal and nonverbal
people who attempt or complete suicide often have….
poor critical thinking skills
troubled emotional lives
low threshold for emotional pain
risk factors for youth suicide
lost parent to suicide childhood maltreatment problematic family relations hx of bullying family hx of suicide socioeconomic problems parental psychopathologic problems peer problems legal/discipline problems
neurobiologic theory of suicide
decreased 5HT linked
biological response to stress
genetic theory
family hx
societal factors theory
no social support
psychological factors theory
psychotic tendencies (command hallucinations)
hopelessness
helplessness
worthlessness
Adolescents and young adults risk factors
strongest: substance abuse, aggression, disruptive behaviors, depression, social isolation frequent running away frequent rage and problem with parents family loss, instability, withdrawal perception of failure expression of suicide difficulty dealing with sexual orientation unplanned pregnancy
older adult risk factors
social isolation solitary living arrangements widowhood lack of financial resources poor health hopelessness most visit their primary care dr within last month
SAD PERSONS
S: sex--male (1) A: age-- <19 or >45 yrs (1) D: depression/hopelessness (2) P: previous attempt/psych care (1) E: excessive ETOH/drug use (1) R: rational thinking loss (2) S: separated, widowed, divorced (1) O: organized plan/serious attempt (2) N: no social support (1) S: stated future intent (1)
0-5: may be safe
6-8: possible psych consult
>8: possible hospital admission
behavioral cues
giving away prized possessions
farewell notes
making will
putting personal affairs in order
failing to sleep/fall asleep more than 1 night in a row
sudden or unexpected improvements in mood
neglecting personal hygiene
lethality of plan
How detailed is the plan?
How lethal is the proposed plan?
How available is the method? (own gun)
assessment of risk
ask assess for precipitating event assess risk factors assess hx or family hx intent, lethality, injury
red flags suicide risk
sudden change from sad to happy
giving away possessions
interventions during the crisis stage
safe environment document pt activity suicide precautions construct verbal or written no-suicide contract encourage pt to talk about feelings
