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18 Cards in this Set

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Pyscodynamics of suicide
1-attempt at communication/cry for help
2. As a mastery over fate- severley depressed people no control over fate(only control is to take own life)
3. Murder turned inward-feelings of strong anger toward others but turn anger to self with suicide
4-escape from painful situations-dysfunctional grieving, gambling, illness
Epidemiology
occurs all ages
need to assess risk factors
age, physical illness, substance abuse, psychiatric disorders, terminal disease, incarceration (high risk)
males >65 are 4x more likely
attempts are more common than completed sucides
Medical risk factors
epilepsy
visual defects-blindness
MS- delibeitating terminal illnesses
brain tumnors
CA
Huntingtons disease-ends in dementia
HIV
ALL HAVE ELEMENTS OF HOPELESSNESS
Psychiatric risk Factors
Substance abuse-increase incidence
depression-always a risk
bipolar disorder-troubles w/ the law
concuct disorder-social norms/rules are violated
Psychiatric risk factors cont
schizophrenia-command hallucinations
panic disorder-cant' tolerate anxiety
personality disorder- such as borderline can't trust/share or get needs met
OCD-can't tolerate symptoms of disorder
Assessment
suicide potential: age and sex
symptoms
stress-state of mind
resources-have no family/friends, homeless, no job, no one to turn to, debt, can see no way out
More assessments
prior suicide behavior-hx of repeated attempts over years
medical status
communication aspects-efforts to reestablish communication are lost
reaction of significant other-punishing, no feelings or concerns. Pt states shame/blame/guilt
Assessment of suicide plan
thinking of suicide ( important) if yes ask...
do you have a plan....
lethality of method-the more lethal the more risky-interventions nn to be done ASAP
when ar eyou plan
ning
need to act
how do you respond when someone plans to kill self
tell them what you are going to do in a calm voice, non judgemental, want to get their trust, tell them you are going to get them help
Common characteristics
ambivalence-wanting to do/then not wannting to do. struggle b/w living and death
Helpless/hopeless-last step before sucide
ID problem clearly
Therapeutic alliance- to whom do you talk with. do you tell anyone how you feel. what do you think make.
what do you want them to talk about
want them to work on their reason to live, best to meet needs to be safe/respect self-esteem
adolescent assessment
warning signs of potential suicide/risk factors/interventions
drastic change in behavior, stated feelings of lonley, despair, alineating behaviors, giving away precious posessions
RF: loss relationship with parents pet, boyfriend
Lifestyle: rejected by family/friends unattainment of a specific
goal-not passing test, no colelge
Assessment of elderly
age/common living alon/lossess/methods
>65
living alone after being with someone for 50yrs. children not around, increased etoh use, pain, sadness
More lethal means: guns/hanging starvation/refusing meds
Planning/goals
verbalize an absence of suicidal ideation, plan and intent
Agree to no-self harm (method of monitoring/checking is asking questions
verbalize a desire to live and list reasons for wanting to live
AGree to inform staff immediately if suicidal feelings or thoughts occur.
Interventions
duty is to protect
goal is to decrease risk in environment if they still intent on hurting self.
precaution and contract for safety.
assign observation level
Observation levels
level 1 1:1
Level 2 in view of staff at all times
Level 3 15min checks (whole unit is on )
How to provide support
refrain from judgeing
listen
accept and validate feelings
reinforce strengths
identify supports
reinforce hope
listen with mind and heart
Help for suicide survivors
disenfranchised grieg- people don't go up to them but avoid them
Opportunity to talk
don't seek blame-it wasn't their fault
offer information-provide practical help
time to heal-support groups
do no abandon
people who complete suicide are lost.