Suicide And Self Harm Flashcards
What are mental health issues are risk factors for or causes of suicide?
Previous suicide attempt: lifetime risk 10-15%
Previous self harm: lifetime risk: 3-5%
Depression: lifetime risk 15%, up to 80% of those who die are depressed
Schizophrenia: lifetime risk 10%
Substance misuse: alcohol dependence lifetime risk 3-4%
Personality disorders:
What physical health problems are risk factors for or causes of suicide?
Chronic illness
Painful illness
Terminal illness
What in a family history is a risk factor for or a cause of suicide?
Mental illness
Suicide
Suicide prevention strategies from the government?
Limiting pack sizes of paracetamol
Installing barriers at suicide hotspots and free telephone for calling the Samaritans
Catalytic converters
What are features of depressed patients at highest risk of suicide?
Older, single Previous self harm Experience recurrent suicidal thoughts Suffer insomnia or weight changes Feel extremely hopeless, worthless or guilty
When are depressed patients most at risk of suicide?
When they are beginning to recover
Gain energy and motivation to act on suicidal ideas
What are reasons for self-harm?
Self-punishment
Substituting psychological distress with physical pain
Overcoming numbness
To change intolerable situations, oft relationship issues
Suicide attempt
Avoiding more dangerous self-harm/suicide attempt
What are the most common forms of self harm?
Self-cutting OD Burning Bruising Self-stabbing
Risk factors for self harm
Lifetime risk: 7-13%
More common in children and adolescents
Assoc with affective disorder and personality disorder
Also substance misuse, past childhood abuse, domestic violence
What aspects of a suicide attempt indicate further increased risk of suicide?
Careful planning Final acts in anticipation Isolation at time of act Precautions taken to prevent discovery Writing suicide note Intent to die Believing method to be lethal Violent method Ongoing wish to die/ regret re failure
What immediate interventions should be made following a suicide attempt?
High risk for further attempts: admission
Lower risk (no longer suicidal, family/friends for support, seeking help): manage in community
Address any immediate risk factors/stressors
Make a plan to deal with future suicidal ideation/thoughts of self harm
Follow up interventions following attempted suicide
Should be arranged within a week following the event/discharge
Via community mental health team/outpatient clinic/GP/counsellor
Treat underlying disorder
Keep prescriptions short and review regularly to avoid stockpiling for OD
Coping strategies / harm reduction
Alternative ways of dealing with painful moods/ situations:
Distraction techniques/mood raising activities
If individuals do not want to stop harming, harm reduction can make the process safer: not sharing blades, basic first aid, cleaning skin before cutting.
Be wary of not condoning self-harm!
What are alternatives to painful damaging self-harm?
Squeeze ice cubes
Snap rubber band around wrist
Bite into something strongly flavoured
What are alternatives to drawing blood?
Red food dye on dull side of knife and draw across skin
Use washable red pen to mark skin instead of cutting
