Suicide prevention and crisis intervention Flashcards
suicide placement on leading cause of death among americans in 2020
12th leading cause
appr how many people died by suicide in 2020
46,000
at highest risk for completing suicide
Single, never-married individuals
Divorce
Widows and widowers
Women attempt suicide more often than men
Men are more likely to complete suicide
Women more likely to overdose
Men more likely to use more lethal means, such as firearms
high school students and suicide
More than 17% (approximately 2.5 million ninth through twelfth graders) have seriously considered suicide
More than 13% have made a suicide plan
More than 8% have attempted suicide
Age risk factor for suicide
Risk of suicide increases with age
-Especially among men
Highest rate of suicide
-Aged 75 or older
religion and socioeconomic status risk factors for suicide
Higher among very highest and lowest social classes
More completed suicides among unemployed
Affiliation with a religious group decreases risk of suicide
highest ethnic group at risk for suicide
native american males
other risk factors for suicide
Individuals hospitalized for a psychiatric illness have 5-10x greater suicide risk
Early in treatment with antidepressants
Severe insomnia
Use of alcohol and barbiturates
Psychosis with command hallucinations
Affliction with a chronic, painful, or disabling illness
Family history of suicide
Loss of a loved one through death or separation
Lack of employment
bullying statistics
41% of youth are victims of physical bullying (most often boys)
17% are victims of cyberbullying
Girls are more likely to be victims of psychological bullying
psychological theories for suicide
Anger turned inward
Hopelessness and other symptoms of depression
Desperation and guilt
History of aggression and violence
Shame and humiliation
3 factors elevating active risk for attempt
- Pain combined with hopelessness
- When pain and hopelessness exceed one’s sense of connectedness to others
- When strong, active suicide ideation is present, it leads to an attempt only if one has capacity to make an attempt (availability of lethal means)
biological theories involved with suicide
Genetics
-Twin studies have shown a much higher concordance rate for monozygotic (identical) twins than for dizygotic twins
Neurochemical factors
-Deficiency of serotonin
–Recent meta-analysis examining biologic factors found they are weak predictors of a future suicide attempt/death
assessment for suicide
Identify (thoughts), plans (intentions), and attempts (behavior)
Distinguish between suicidal self-injury and non-suicidal self-injury
Risk level
screnning for depression and passive SI
PHQ2
PHQ9
screening for suicide
Columbia-Suicide Severity Rating Scale (C-SSRS)
-Assesses passive and active SI
-Method, plan, intent to act upon plan, suicidal behavior
Ask Suicide Screening Questions (ASQ)
-4 yes/no screening questions
-Toolkit
SAFE-T
-Identify risk factors and protective factors
-Conduct a suicide inquiry
-Determine risk level and interventions
-Document a treatment plan
factors to consider with pt history in suicide
Age
Gender
Ethnicity
Marital status
Socioeconomic status
Occupation
Religion
Family history of suicide
Military history
Interpersonal support system
Analysis of the suicidal crisis
-Precipitating stressor
-Risk factors
-Relevant history
-Life-stage issues
Psychiatric/medical/family history
Previous psychiatric treatment
Medical history
Coping strategies/past strategies
diagnoses examples for suicide
Risk for suicide related to feelings of hopelessness and desperation
Hopelessness related to absence of support systems and perception of worthlessness
outcomes of the client for suicide risk
Has experienced no physical harm to self
Sets realistic goals for self
Expresses some optimism and hope for the future
planning and implementation for suicide
Establish rapport and promote a trusting relationship
Address client’s feelings in a nonjudgmental manner
Be direct and listen actively
Talk openly and matter-of-factly about suicide and encourage expression of feelings
Discuss the current crisis situation in the client’s life using the problem-solving approach
Help the client identify areas of life that are within his or her control and those that cannot be controlled
DBT and CBT
information for family and friends of individuals with SI
Take any hint of suicide seriously
Do not keep secrets
Be a good listener
Stress that the person’s life is important to you and to others
Express concern for individuals who express thoughts about killing themselves
Familiarize yourself with suicide intervention resources
Restrict access to firearms or means of self-harm
Communicate caring and commitment to provide support
suggestions for families and friends of individuals with SI
Try to give them hope
Do not leave him or her alone
Show love and encouragement
Seek professional help
Do not judge or show anger toward the person or provoke guilt in him or her
strategies for assisting survivors of suicide victims
Encourage him or her to talk about the suicide
Discourage blaming and scapegoating
Listen to feelings of guilt and self-persecution
Talk about personal relationships with the victim
Recognize differences in styles of grieving
Assist with development of adaptive coping strategies
Identify resources that provide support
long-term goals of psychotherpy for clients with SI
Develop and maintain a more positive self-concept
Learn more effective ways to express feelings to others
Achieve successful interpersonal relationships
Feel accepted by others and achieve a sense of belonging
as sudden event that disturbs homeostasis in one’s life
crisis
