Suicide

REALITY OF SUICIDE

  • Definition: Suicide is defined as self-inflicted death with the intent to die.

  • Seriousness of Threats: Always take threats or attempts seriously.

  • Prevalence of Thoughts: Many people may have suicidal thoughts, but not all individuals act on them.

  • Universality: Suicide can happen to anyone, irrespective of background or circumstances.

INDIVIDUALS AT HIGHEST RISK

  1. Native Americans

  2. LGBTQ+ individuals

  3. Veterans

  4. Incarcerated individuals

  5. Youth in foster care

  6. Older adults

COMMON SUICIDE MYTHS

  • Myth 1: Talking about suicide encourages it.

    • Truth: Talking about suicide helps reduce feelings of isolation and can save lives.

  • Myth 2: Only people with mental illness commit suicide.

    • Truth: Life stressors can overwhelm anyone, leading to suicidal thoughts or actions.

  • Myth 3: Those who talk about suicide won't actually do it.

    • Truth: About 80% of individuals contemplating suicide give clues or warnings prior to the act.

  • Myth 4: Once someone attempts suicide, they won’t do it again.

    • Truth: Between 50% to 80% of completed suicides had at least one prior attempt.

  • Myth 5: Individuals who attempt suicide just want attention.

    • Truth: All suicide attempts should be taken seriously, regardless of perceived motivations.

RISK FACTORS FOR SUICIDE

  • Prior suicide attempt

  • Family history of suicide or violence

  • Substance or alcohol use

  • Isolation and lack of support

  • Physical illness or chronic pain conditions

  • Recent loss or experiences of grief

  • Access to lethal means: such as guns or pills

  • Impulsive or aggressive behavior

WARNING SIGNS

  • Expressing a desire to die or stating they feel like a burden to others.

  • Statements: Such as “You’d be better off without me.”

  • Researching methods of suicide.

  • Giving away belongings or pets, indicating preparation for death.

  • Sudden calmness after a period of deep depression, often mistaken for improvement.

  • Engaging in reckless or risk-taking behaviors.

NEUROLOGICAL AND PSYCHOLOGICAL CAUSES

  • Link to Serotonin: Decreased serotonin levels are associated with increased suicide risk.

  • Perception of Suicide: May be seen as a way to escape emotional, physical, or psychological suffering.

  • Hopelessness: This includes feelings of guilt, shame, and anger towards oneself.

  • Command Hallucinations: Such voices may instruct the individual to harm themselves.

SUICIDE SCREENING TOOLS

  • Columbia Suicide Severity Rating Scale (C-SSRS):

    • A standardized screening tool that evaluates the severity and immediacy of suicidal thoughts or actions.

  • Ask Suicide Screening Questions (ASQ):

    • A rapid 4-question screening tool designed for individuals aged 10 years and older.

TREATMENT AND SUPPORT

  • Seriousness of Suicidal Thoughts: Always take these thoughts seriously and seek help.

  • Emergency Psychiatric Care: Always necessary when needed.

  • Therapy Options:

    • Individual therapy

    • Group therapy

  • Medications: For conditions such as depression, anxiety, and psychosis.

  • Hospitalization: May be necessary for high-risk individuals to ensure safety.

  • Hotlines: Availability of resources 24/7.

NURSING INTERVENTIONS

  • Monitoring:

    • Conduct frequent checks at unpredictable times.

  • Safety Maintenance:

    • Remove potential means such as sharp objects, cords, razors, glass items, and belts.

  • Communication:

    • Engage directly and calmly, ensuring to listen actively.

  • Immediate Reporting:

    • Never keep secrets about any suicide plans; report them immediately.

  • Education:

    • Provide patient and family education concerning the issues around suicide and support options available.