Suicide Flashcards
Suicide is the most common cause of death in which cohort of the population?
Men under the age of 45
How many more times common is suicide in men in comparison to women?
three
What are the most common methods of suicide?
hanging, strangulation, suffocation and poisoning (mainly from overdose of medication most commonly paracetamol, heroin and alcohol)
Risk factors for suicide?
- Previous suicide attempt or previous self-harm
- Male gender (3x more common than women)
- Age – currently highest aged 40-44
- Current mental disorder or previous psychiatric treatment
- Unemployment, recent loss of job
- Homelessness
- Alcohol or drug abuse
- Physically disabling or painful illness, including chronic pain
- Low socio-economic status
- Certain professions higher in vets, doctors, dentists
- Lack of social support/living alone
- Significant life events bereavement, family breakdown
- Institutionalised prison, army
- Bullying
How many times higher is the risk for suite in patients with mental disorders than those without?
5-15 times higher
What do you assess when assessing someone for attempted suicide?
The act itself
assess current intent and plans
risk factors
assess their needs (e.g. social, physical or psychological Sx)
What questions do you ask about the act itself?
- How did they do it what did they use?
- Why did they do it, what happened today
- Did they plan? Leave any notes? Wills?
- How do they feel now, do they feel regretful? Sad/Happy it didn’t work?
What are you assessing with regards as to their current intent and plans with regards to suicide?
- Wish to be dead
- Feelings of hopelessness
- Regret/remorse over current/previous attempt
- Expectation bout outcome of self-harming behaviour or suicide attempt/threat
- Specific plans
- Lethality and frequency of plans or attempts
- Other self-harming behaviour
- Assess current suicidal intent/wishes
- Length of time the suicidal feelings have been present
- Plans for others after death notes, changes to will, consequences
what risk factors are assessed?
• Assessment of mental health
o Past psychiatric history
o Depressive and other psychiatric Sx
o Medication
o History of alcohol or illicit drug use
o Observation of verbal and non-verbal indicators of mental state
o Previous self-harm or suicide attempts
o Age, gender, social situation
o Relationships which may be supportive/protective or may pose a threat (abuse/neglect)
o Access to lethal methods e.g. anaesthetist, pharmacist
o Any protective factors?
What needs are assessed?
- Social problems
- Untreated mental health disorders
- Physical symptoms and disorders
- Coping strategies
- Psychosocial and occupational functioning
- Personal and financial difficulties
- Needs of dependants
What may be included in the mx plan for suicide attempt/suicidal?
- Prevent self-harm or suicide attempts
- Reduce level of injury from self-harming behaviour
- Improve QoL
- Improve social and occupational functioning
- Improve mental health conditions
- Improve physical symptoms
- TREAT CO-MORBID CONDITIONS
What specific treatment options are available for suicidal patients?
Medication - SSRIs, alcohol detox, anxiety medication etc.
Counselling
Psychotherapy esp CBT
Follow up of pt at regular intervals
