psych week 7: mood disorders/suicide

suicide epidemiology

• suicide, the tenth leading cause for all ages

• men commit the majority of completed suices

• women attempt 3-4 times more often than men

• highest incidence of suicide is in the elderly (>80)

levels of suicidal behavior

• suicidal ideation

• suicidal threats

• suicidal gestures

• suicidal attempts

• successful or completed suicides

risk factors for suicide

assessment for suicide

• all PMH pts should be assessed frequently for suicidial and homicidal ideations

• is there a plan?

• how lethal is the plan?

• does person have means to carry out plan?

• has the person attempted suicide in the past?

  • how often, when, methods, circumstances

• family history of suicide

• other risk facots: loss, lack of suppot, poor impulse control, substance use/abuse

suicide: nursing interventions and treatments

• instill hope

• establish a theapeutic relationship

• safety

safety for suicide

• initiate suicide precautions according to policy

• remove all sharps: glass, razors, scissors, knives, rigid plastic, metal

• remove electrical cords (unless short), belts, shoelaces, other items that could use to hang/suffocate

• lock windows or prevent access

• search belongings with patient witnessing and security present and remove any potentially dangerous items

• inspect all items brought in

• accompany to bathroom or any other areas

• reassure that purpose is safety and not punishment

• observe affect

• contract for safety

• continually monitor environment

• suicide precautions (1:1, q15min checks)

family needs

• anger, guilt, shame

• taboo topic

• less social support than for other type of death

• few seek treatment

• caregivers may be traumitized

• refer to support groups or counseling

self awareness issues

• nruses and other staff members need to deal with their own feelings about suicide