Suicide

Risk Factors

  • Single more than married

  • Change in Marriage status (Divorce)

  • Sex

    • Women attempt more but men are more successful

  • Age

    • increases in age (45-65)

  • Religion

    • decreases but not against ideation

  • Poverty

  • Ethnicity

    • white people and natives

  • Psychiatric Illness

    • mood and substance

  • Previous Attempts

    • half that complete have tried before

Theories

  • anger inward

  • shame and humiliation

  • hopelessness

Suicidal Ideation

  • Ideation current

  • Substance Abuse

  • Purposelessness

Assessment

  • Demographics

    • Occupation- High stress increases risk

  • Any diagnosis

  • Ideas or Acts

    • plans?

    • any means?

      • lethality of means

  • Protective Factors

    • resilient temperament→

    • Social competency

    • problem solving skills

    • perception of and actual

  • Analysis of the Suicidal Crisis

    • precipatory stressos

    • relevant history

    • life-stage issues

  • HX

    • phychiatric

    • medical

    • family

  • coping strategies

    • in any and all disorders

  • presenting symptoms

CAMS Model

  • identifies strategies for enhancing a collaborative, therapeutic relationship and communication about suicide

    • normalizing

    • ask about behavioral events

    • gentle assumptions

    • denial of the specific

Outcome Criteria

  • has experienced no harm

  • optimism and hope for future

Intervention on Outpatient Basis

  • Ensure access to support systems and tie to system of care

  • Develop a detailed safety plan

  • help of family and friends

  • Schedule frequent appointments

  • Establish rapport and promote a trusting relationship

Guidelines

  • Be direct and talk matter of fact

  • discuss the current crisis situation in patients life

  • listen actievly

Family and Friends

  • TAKE ANY HINT OF SUICIDE SERIOUSLY

  • Do not keep secrets

  • be a good listener

  • express feelings of personal worth to the client

    • tell them how much they mean to you

  • KNow prevention resources

  • Accept and Acknowledge patients feelings

  • Do not leave them alone

  • remove children from home

  • no anger and guilt to patient

After a Successful Suicide

  • family becomes patient

  • adaptive coping

  • encourage them to talk about suicide

  • no scapegoating or blaming

  • talk about personal relationships with the victim