Suicideology Flashcards
1
Q
- ___ people per day commit suicide (2014)
- ___th leading cause of death
- ___% suffer from a diagnosable mental illness
A
- 117
- 10th, more than car accidents
- 90%, mostly depression
2
Q
- Massachusetts is the ____th ranked state for suicides (2014)
- Massachusetts suicide rate is (increasing or decreasing).
A
- 48th
2. increasing by about 3.6%
3
Q
Suicide Treatment Best Practices:
A
- Understanding Suicide
- Risk and Protective Factors
- Managing Reactions
- Therapeutic Empathy
- Eliciting the Narrative
- Measures and Tools
- Assigning Level of Risk
- Crisis Intervention
- Treatment Overview
- Standard of Care
- Postvention, grief, loss
- Hope and self-care
4
Q
- Number who think about suicide
- Number who plan a suicide
- Number who attempt suicide
- Number of suicide deaths
(2013)
A
- 9,000,000
- 2,700,000
- 1,300,000
- ~ 38,000
* HUGE difference between attempts and deaths
5
Q
Language of Suicide
- crime, a sin
- successful, failure
- suicide gesture
A
- you commit crimes, sins, and suicide
- a successful suicide attempt = death, a failed attempt = live –> maybe we shouldn’t equate failure with living
- self-injury without attempting to kill yourself, unclear what this term means, speaker didn’t like it
6
Q
Venn Diagram
- Those who desire suicide
- Intersection
- Other Circle
A
- perceived burdensomeness, thwarted belongingness
- Those who attempt suicide
- those who are capable of suicide
- people have a very strong innate survival instinct - so what does it take for someone to be able to override that?
- foot in the door phenomenon -> you get used to thinking about suicide, and then you get used to the planning, and over months the actual suicide doesn’t seem like so much
7
Q
Risk Categories
A
Those we can't change: --- Previous Attempts --- Family History --- Medical Factors --- Demographic Factors Those we can change: --- Cognitive Style --- Access to means to commit suicide --- Psychosocial factors (social support) --- Clinical factors --- Substance abuse/addiction
8
Q
Means Reduction: states with high and low percent of gun ownership
A
- States with high gun ownership have way more fire-arm suicides, but high and low states have about the same number of non-fire-arm suicides --> people do not find another way High Gun Ownership States: -- population: 39 million -- 47% gun ownership -- 9,749 fire-arm suicides -- 5,060 non-fire-arm suicides Low Gun Ownership States: -- population: 40 million -- 15% gun ownership -- 2,606 fire-arm suicides -- 5,446 non-fire-arm suicides
9
Q
How does a suicide occur?
1 –> 2 –> 3 –> 4a –> 5a
1 –> 2 –> 3 –> 4b –> 5b
A
- Underlying vulnerability
- Stress event
- may be caused by underlying vulnerability (1. depression, 2. depressive episode) - Acute Mood Change
- anxiety, dread, hopelessness, anger
4a. Inhibition
- social taboo, slowed mental state, social support
4b. Facilitation
- available means, agitation
5a. Survival - no suicide attempt
5b. Suicide
10
Q
Warning Signs (Acronym)
A
- IS PATH WARM?
- Ideation, Substance use
- Purposelessness, Anxiety, Trapped, Hopelessness
- Withdrawal, Anger, Recklessness, Mood
11
Q
Youth
A
- 2nd highest cause of death
- Impulsivity
- Influence of media
- LGBTQ
- Attention-seeking
- – if they need attention, give it!
12
Q
Protective Factors
Assessment: Reasons for Living Inventory
A
- Availability of Physical and mental health care
- Restrictions on lethal means of suicide
- Safe and supportive school and community environments
- Sources of continued care after psychiatric hospitalization
- Connectedness to individuals, family , community, and social institutions
- Supportive relationships with health care providers
- Coping and problem solving skills
- Reasons for living (e.g. children in the home)
- Moral objections to suicide
13
Q
Managing your reactions
A
- Therapist reacts emotionally to hearing client’s suicidal
- fear, anxiety, anger
- Emotional reactions lead to mistakes
14
Q
Eliciting the Narrative: what not to say
A
- you are not thinking of committing suicide, are you?
- be smart when choosing your words
15
Q
How to Ask About Ideation
A
Ask about onset, duration, frequency, active/passive, lethality, underlying intent, triggering events, what intensifies the thoughts, what distracts the thoughts, association with states of intoxication, understanding of consequences.
- Ideation/plan is a coping strategy
- If depressive symptoms are severe, don’t accept denial at face value
- – ask why they are not suicidal (reasons for living)
