Term
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Definition
| suicide is the 10th leading cause of death in the US, for every suidide 25 attempts. firearms account for almost 50% of all suicides. men die by suicide 3.5x more often than women. white males accounted for 7 of 10 suicides in 2015. the rate of suicide is hihgest in middle age |
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| inc suicide where ther is inc |
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Definition
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| race/ethnicity with highest suicide rate |
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Definition
| white, american indian/alaska native |
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| percentage of high school students who have considered suicide |
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Definition
female- almost 25 %
male- 12% |
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Term
| Etiology of Suicidal Behavior |
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Definition
• Multifactorial:psychological,biologic,genetic, social, and environmental factors
• 90%ofpeoplewhodiebysuicidehavea diagnosed psychiatric disorder
– Most prevalent that are associated with suicide are major depressive disorder and substance abuse |
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Term
| disorders w inc risk of suicide |
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Definition
| anorexia nervosa, sedative/hypnotic/anxiolytic dependence, mixed drug dependence and abuse, major depressibe disorder, bipolar disorder, mood disorder not otherwise specified, neurosurgery |
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Term
| Pathophysiology: of suicidal behavior |
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Definition
– Genetic and environmental factors
– Serotonin pathways have been found to be involved in suicidal behaviors
• Independent of serotonin abnormalities found in depression
– Genetic studies focus on serotonin-related genes
– Additional factors thought to be involved:
• Noradrenergic system, dopaminergic system, HPA axis stress-response function |
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Term
Suicideriskassessment:The7D’s
Did you... |
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Definition
– Develop an empathetic and respectful relationship?
– Define the problem(s) suicide would solve?
– Detect suicide ideation?
– Determine desire, capability, intent, and
means availability?
– Detail risk and protective factors?
– Decide on level of acute risk present?
– Develop a collaborative crisis mitigation, means restriction, and follow-up plan? |
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Term
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Definition
• Keep in mind...
– Most people do not self-refer for help
– Most people do not know they are depressed
• We(providers) need to reach people before they make an attempt
• We (providers) need to take all warning signs seriously |
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Term
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Definition
Talking about suicide
Social withdrawal
Mood changes
Seeking suicide means
Substance abuse
Talking about being a burden to others
Acting anxious, agitated, reckless
Talking about feeling trapped or being in unbearable pain
Rage and talking about revenge
Talking about hopelessness or no reason to live
Past attempts
Triggering events |
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Term
| out of all who desire suicide... |
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Definition
| not that many are capable of suicide |
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Term
| Perceived burdensomeness: |
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Definition
– Feeling ineffective to the degree that others are burdened is among the strongest sources for the desire for suicide
• “Feel that I am a burden to my family”
• “Feel that everyone will be better off without me” |
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Term
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Definition
– Our need to belong to valued groups and relationships is so powerful that, if frustrated or thwarted, serious negative health consequences follow—including suicide
• “Feel like I don’t belong”
• “Feel like no one cares if I live or die”
How do we know? ASK!!! |
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Term
| QPR: Question, Persuade, Refer |
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Definition
Ask a question, save a life
– Most suicidal people send warning signs
– Warning signs can be taught
– Gatekeepers can be trained to (a) recognize suicide warning signs and (b) intervene with someone they know
– Gatekeepers must be fully supported by policy procedure and professionals in their community |
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Term
| Suicide Primary Prevention |
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Definition
• Reducing risk factors
• Promoting protective factors
• Examples: Education, security and netting at bridges, monitoring security of high-rise windows |
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Term
| Suicide Secondary Prevention |
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Definition
• Services offered after event
• Addresses short- term impact and effects of suicide
• Examples: Crisis counseling in aftermath, campus debriefings |
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Term
| Suicide Tertiary Prevention |
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Definition
• Long-term responses and plans
• Address after-effects and consequences of suicide
• Examples: Ongoing support groups for survivors, system- wide improved coordination
of services |
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Term
| A CDC study found that 24% of nearly lethal suicide attempts occurred |
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Definition
| less than five minutes after the person decided on suicide |
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Term
| At least 1 in 3 youth suicides followed within 24 hours of a crisis like |
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Definition
| arrest, family argument, or relationship breakup |
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Term
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Definition
– Firearms: Most common method of suicide
– Medications: Most commonly used in suicide attempts
– Alcohol: Increases risk of suicide attempts and the lethality of the attempt |
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Term
| 85% of firearms used in youth suicide come from |
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Definition
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Term
| Suicide Prevention: Counseling |
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Definition
• Ask direct and nonjudgmental questions about suicidal thoughts and past suicide attempts
• Ask about plans and access to means – Prior methods of self-harm considered?
– Known access to lethal means?
• Work with individual and family members to reduce access to lethal means
Talking about suicide REDUCES the risk of suicide |
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Term
| Counseling: Questions to Ask |
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Definition
• Sometimes when people have gone through what you are going through, they’ve thought about killing themselves. Have you had any thoughts like this?
– Have you found yourself thinking you’d be better off dead?
• Tell me the couple of times you felt the worst, either the saddest or most angry or trapped. Did you think about suicide? What did you do?
• Have you ever attempted suicide? |
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Term
| Counseling: Addressing Parents |
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Definition
• Always speak with the parents privately
• Speak with the gun owner, not just the adult at the appointment
• Discuss all of the youth’s homes
• Do not assume hiding places are safe for weapons or medications
• Do not inform youth of gun in the home if they have not addressed knowing this; still ensure it
is removed
• Set specific plan: Who will remove the weapon and when? Document this in your notes and follow up. |
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Term
| Suicide Prevention: Medication Management |
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Definition
• Specific strategies:
– Use lower-toxicity medications if possible
– Limit dosing quantities (1 week vs. 1 month)
– Consider use/access to alcohol and other medications including OTC medications
– Remove unneeded medications from the home
– Use tamper-proof lock box for high-risk medications:
• Rx painkillers, anxiety medications, amphetamines, sedatives
• Bedeliberateinyourwordchoice:
– “I’m going to write your prescriptions on a weekly basis so we are able to check in more as you mentioned still having suicidal thoughts at times. This is a safer amount, but it can still be harmful if too many pills are taken at once; let’s take a few minutes before you leave today to discuss your safety plan if you do start feeling suicidal again.” |
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Term
| suicide Counseling: Key Takeaways |
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Definition
• Directly discuss concern for suicide
• Ask about access to lethal means
• Explain (to all involved parties) that restricting access reduces risk
• Make a specific plan to reduce access
• Refer to the necessary specialists
• Follow up frequently and monitor progress |
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