Suicide and Non-Suicidal Self-Injury Study Notes

Definitions and Prevalence

  • Suicide is the intentional act of killing oneself, ranking as the tenth leading cause of death overall, and particularly prominent in individuals aged 10-24.

Key Risk Factors

  • Major risk factors include:

    • Alcohol or substance use disorders

    • Male gender

    • Increasing age

    • Psychiatric conditions (e.g., depression)

    • Lack of social support (e.g., being unmarried)

    • Certain stressful professions

    • Poor physical health

Biological and Psychosocial Contributors

  • Biological factors: Genetics, family history, and neurobiological aspects such as low serotonin levels.

  • Psychosocial theories: Motivations like aggression turned inward (Freudian theory), a combination of wishes (Menninger's theory), and hopelessness (Aaron Beck's contributions).

Cultural and Societal Influences

  • Cultural protective factors: Strong religious adherence and family support (especially among African Americans, Hispanic Americans, and Asian Americans).

  • Societal influences: Legislation like Oregon

Nursing Process: Assessment and Intervention

  • Assessment:

    • Identify overt (direct) and covert (indirect) statements of suicidal intent.

    • Evaluate the lethality of any disclosed plan.

    • Utilize the SAD PERSONS Scale to assess suicidal potential:

      • Scores factors like sex, age, depression, previous attempts, and lack of social support.

      • Scores guide decisions:

        • 0-2 points: Patient can often be sent home with follow-up.

        • 7-10 points: Immediate hospitalization is typically necessary.

Levels of Intervention

  1. Primary: Prevention through education and support.

  2. Secondary: Treatment during a suicidal crisis.

  3. Tertiary: Support for survivors of suicide.

  • Nursing interventions involve:

    • Teamwork

    • Counseling

    • Health teaching

    • Case management

    • Pharmacological approaches

  • Advanced practice roles: Psychotherapy and psychobiological interventions.

  • Clinical observation: Reassess suicidality in patients showing rapid improvement, as this may indicate increased energy to act on suicidal thoughts.

Nonsuicidal Self-Injury (NSSI)

  • Nonsuicidal self-injury also involves biological, cultural, and societal factors, and is a distinct but related concern.