Term
**US suicide statistics:
-rate
-deaths/year
-ranking in cause of death |
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Definition
*11.5/100,000
*35,000 deaths per year
*11th leading cause of death |
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Term
| prevalence rates or sub-populations |
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Definition
-highest among elderly
-M>F (more F attempts)
-Alaska and mountain states
-higher in high stress professions that have access to lethal means (docs, cops, military) |
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Term
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Definition
-previous attempts is the best predictor
clinical RF:
depression
alcohol/drug abuse
schizophrenia
other psychiatric disorder |
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Term
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Definition
~50% of completers were clinically depressed at the time of suicide
-can occur in all phases of suicide
~15% of all persons with significant mood disorders will commit suicide |
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Term
| substance abuse and suicide |
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Definition
~1/3 of all suicides occur in persons diagnosed with chronic alcoholism
+blood-alcohol levels in 30-40% of suicides |
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Term
| schizophrenia/other mental disorders and suicide |
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Definition
~5% of suicides are schizophrenics
-5-10% of schizophrenic patients commit suicide, increased with other mental disorders |
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Term
| medical and psychosocial risk factors |
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Definition
serious physical illness
social isolation/interpersonal loss or conflict |
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Term
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Definition
hopelessness
acute agitation
intoxication
psychosis (esp. with command hallucinations/delusions) |
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Term
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Definition
older
white
male
living alone
not working |
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Term
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Definition
depression
substance abuse
psychosis
other psych disorders |
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Term
|
Definition
suicidal ideation
hopelessness
agitated
command hallucinations/delusions |
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Term
|
Definition
medical illness
recent loss
intractable dilemma
prospect of public humiliation |
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Term
| general principles of intervention |
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Definition
-recognize cry for help or expressed ideation/intent
-ask ?'s in objective, straighforward, nonjudegemental manner
-assess depression, substance abuse, impulsivity, psychosis
-ask specifically about availability of firearms
-do not alienate the patient with sarcasm, ridicule, or disbelief
-do not minimize their perceived problems
-talk calmly and openly about problems
-convey a sense of hope; counteract hopelessness
-always seek corroborative information
-ask the tough questions that need to be asked |
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Term
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Definition
-carefully assess protective factors: demographic, family, friends, no past attempts)
-involve family and friends whenever possible
-convey knowledge that depression/other is treatable
-discus the case with another clinician |
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Term
| indications for hospitalization |
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Definition
-attempt is clinically serious
-RF suggest high risk
-no established outpatient care
-discrepancy between patient story and other info
-psychosis |
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Term
| indications suggesting outpatient care |
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Definition
-relatively low risk
-stressors can be immediately addressed
-patient already has a mental health provider
-other safeguards can be implemented (e.g. family support)
-threat/attempts are repeatedly used to communicate distress or manipulate others |
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Term
| steps to take when a patient communicates a suicidal though |
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Definition
-ask questions
-listen carefully
-consult as needed
-treat mental disorders
-remove the means |
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