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18 Cards in this Set
- Front
- Back
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Pyscodynamics of suicide
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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 |
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Epidemiology
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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 |
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Medical risk factors
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epilepsy
visual defects-blindness MS- delibeitating terminal illnesses brain tumnors CA Huntingtons disease-ends in dementia HIV ALL HAVE ELEMENTS OF HOPELESSNESS |
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Psychiatric risk Factors
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Substance abuse-increase incidence
depression-always a risk bipolar disorder-troubles w/ the law concuct disorder-social norms/rules are violated |
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Psychiatric risk factors cont
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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 |
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Assessment
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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 |
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More assessments
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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 |
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Assessment of suicide plan
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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 |
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how do you respond when someone plans to kill self
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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
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Common characteristics
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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. |
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what do you want them to talk about
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want them to work on their reason to live, best to meet needs to be safe/respect self-esteem
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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 |
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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 |
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Planning/goals
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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. |
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Interventions
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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 |
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Observation levels
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level 1 1:1
Level 2 in view of staff at all times Level 3 15min checks (whole unit is on ) |
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How to provide support
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refrain from judgeing
listen accept and validate feelings reinforce strengths identify supports reinforce hope listen with mind and heart |
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Help for suicide survivors
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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. |
