Suicide

Question 1

How many people suicide per day in Australia and how many attempt?

Answer 1

8 per day, 200 attempts

Question 2

Who is most likely to commit suicide?

Answer 2

males 18-24 second most likely behind males over 65

Aboriginal people 2-3x higher

Question 3

What are the four most common methods?

Answer 3

firearms, hanging, carbon monoxide and poisoning.

However may be unknown suicides from deaths in motor vehicle accidents

Question 4

When were there peaks in rates of suicide?

Answer 4

Peak during great depression in males, less during WW2, 60’s rise in women and more stable now

Question 5

How commonly do suicides occur in clusters and what cab be done?

Answer 5

5%, mostly adolescents. Romive child from environment, CISD (controversial)

Question 6

What are factors for suicide?

Answer 6

Depression, previous attempt (25-50%), alcohol, recent loss, organised plan (greatest factor), schizophrenia, bulimia

Question 7

What is included in the criteria for Non-suicidal self-injury?

Answer 7

a) In last yr engaged in damage to surface of body on 5+ days
b) expectation- obtain relief, resolve interpersonal conflict, induce pos state
c) assoc with- interpersonal difficult or neg feeling, prior preoccupation of act, thinking of it often

Question 8

What is the criteria for suicidal behaviour disorder?

Answer 8

a) attempted within 24months
b) Doesn’t meet criteria for non-suicidal self-injury
c) not just ideation or during delirium/confusion
d) not for political/religious objective

Question 9

What are the five components of a suicidal assessment interview?

Answer 9

1) evaluating for depression (assess for hopelessness)
2) explore ideation (frequency, duration, intensity)
3) assess for plans (past attempt/lethality and SLAP)
4) Assess for self-control (ideally in middle)
5) Assess intent (rate on scale)

Question 10

What are some immediate interventions?

Answer 10

Remove means, be empathetic, identify ambivalence, system of safety (put checks in place, remove medications etc.)

Question 11

Why is problem solving an important intervention and how is it done?

Answer 11

Stress-diathesis model (suicidal people have poor problem solving skills and under stress fail to create solutions)
Help learn methods to solving problems (attitude toward problem solving, how to generate alternative, difference between assumptions and fact, practice)

Question 12

What are the major findings from the YARDS project?

Answer 12

• Follow up should be immediate (ideally within 24-48 hours)
• A “green card” referral system aids compliance
• Appointment times should be convenient
• Presentations for depression/loss in adolescents should be assessed for suicidal ideation
• Storage of household medication should be public health issue