Suicide, Violence and the Mental Health Act Flashcards
What is suicide?
The voluntary and intentional act of killing oneself. It is an action, not an illness. Aggression directed inwardly.
What is parasuicide?
Gestures and attempts that are unsuccessful and of low lethality.
What is suicidal ideation?
Thinking about and planning one’s own death.
Which ethnicities are most effected by suicide?
Most common in caucasians and aboriginals.
Which age groups are most likely to commit suicide?
Youth (15-24) and elderly (65+)
Which gender is most likely to commit suicide?
Males (most successful). Females attempt more, but not as lethal.
What are some risk factors of suicide?
Family disruption and dysfunction. Childhood trauma or abuse. Family or personal history of suicide. Widowed, divorced, separated, single individuals. Recent losses. Alcohol use. Physical illness, chronic pain. Psychiatric disorders.
What are the five levels of suicidal behaviour?
Ideation Threats Gestures Attempts Completed suicide
How should suicide be assessed?
Observe behaviour Assess risk factors History from the patient Information from family/friends History of previous gestures or attempts. Mental status exam Physical exam Nursing intuition
What are some assessment criteria for assessing suicide?
Imminence (24 hours) vs non-imminence.
- immediate danger (specific time period)
- specific plan
- access to the means
- admission of wanting to die
Ideation vs. Intent
Severity Index for Suicide Risk
What is a possible nursing diagnosis for a suicidal patient?
Risk for suicide/self-directed violence.
What are the treatment goals for a suicidal patient?
Free from self harm/suicide ideation
Verbalizes desire to live, self-worth, goals, future plans
Contracts for safety
Mood improved
Spontaneous interactions
Effective coping, support system
What are some nursing interventions we can do for suicidal patients?
Safety (put them in pajamas, closer to the nursing station, etc.)
Coping skills
Documentation
What is done during the evaluation step of the nursing process with a suicidal patient?
Assessment is ongoing
Importance of crisis planning when well.
What is the definition of anger?
An affective state experienced as the motivation to act in ways that warn, intimidate, or attack those who are perceived as challenging or threatening; temporary state of emotional arousal; strong and uncomfortable.
What is the definition of aggression?
behaviours or attitudes that reflect rage, hostility, and
the potential for physical or verbal destructiveness
What are some risk factors for violence?
Aggression learned, family role modeling
Alcohol and drug abuse
History of violence
Mental health disorders
Lack of coping skills
Medical conditions
Mental disabilities, low IQ
What are some assessment criteria for violence?
Increase in motor agitation
Threatening verbalizations
Intensification of affect
Prior history of assaultive behaviour
What are some examples of increased motor agitation in a potentially violent patient?
Pacing
Inability to sit still
Sudden cessation of motor activity
What are some examples of threatening verbalizations in a potentially violent patient?
Retaliation towards those seen as threats.
Response to threatening visual/auditory hallucinations.
Response to delusional thinking.
What are some examples of intensification of affect in a potentially violent patient?
Tense expression
Jumpiness
Elated expression
What are some examples of prior history of assualtive behaviour in a potentially violent patient?
Has acted violently in the past
Has been violent under stress in the past
This is the single best predictor
What are the four levels of crisis development in a violent situation?
- Anxiety
- Defensive/Anger and Hostility
- Acting out
- Tension reduction
What are some signs that someone is at the “anxiety” level of crisis development? (violence)
Change, restless, excess energy, pacing, wringing hands, muttering
