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Flashcards in Suicide Deck (51)
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1

What percentage of suicide attempts are due to overdose?

70-90%

2

What percentage of overdoses are "successful"?

2-11%

3

What are the top two causes of death in 15-24 year olds?

1. Accidents
2. Suicide

4

What precipitates most adolescent suicide attempts?

Interpersonal conflicts (relational conflict)

5

Pneumonic for Warning Signs of Suicide

IS PATH WARM

6

What does IS PATH WARM stand for?

I: ideation
S: substance abuse
P: purposelessness
A: anxiety
T: trapped
H: hopelessness
W: withdrawal
A: anger
R: recklessness
M: mood change

7

QPR in Suicide Prevention

Q: question
P: persuade
R: refer
Suicide form of CPR

8

What is the intention of QPR?

Offer hope through positive action

9

Types of Direct Verbal Clues

"I've decided to kill myself"
"I wish I were dead"
"I'm going to commit suicide"
"I'm going to end it all"
"If (such & such) doesn't happen, I'll kill myself."

10

Types of Indirect Verbal Clues

"I'm tired of life, I just can't go on."
"My family would be better off without me."
"Who cares if I'm dead anyway"
"I just want out"
"I won't be around much longer"
"Pretty soon you won't have to worry about me"

11

Behavioral Clues of Suicidal Patients

Any previous suicide attempt
Acquiring a gun or stockpiling pills
Co-occurring depression, moodiness, hopelessness
Putting personal affairs in order
Giving away prized possessions
Sudden interest or disinterest in religion
Drug or alcohol abuse, or relapse after a period of recover
Unexplained anger, aggression, and irritability

12

Situational Clues of Suicidal Patients

Being fired or expelled from school
A recent unwanted move
Loss of any major relationship
Death of a spouse, child, or best friend
Diagnosis of a serious or terminal illness
Sudden unexpected loss of freedom/fear of punishment
Anticipated loss of financial security
Loss of a cherished therapist, counselor, teacher, or pet
Fear of becoming a burden to others

13

Tips for Asking the Suicide Question

If in doubt, don't wait, ask the question
If the person is reluctant, be persistent
Talk to the person alone in a private setting
Allow the person to talk freely
Give yourself plenty of time
Have your resources handy

14

Less Direct Approach on Asking the Suicide Question

"Have you been unhappy lately?"
"Have you been very unhappy lately?"
"Have you been so very unhappy lately that you've been thinking about ending your life?"
"Do you ever wish you could go to sleep and never wake up?"

15

Direct Approach to Asking the Suicide Question

"You know, when people are as upset as you seem to be, they sometimes wish they were dead. I'm wondering if you're feeling that way too?"
"You look pretty miserable, I wonder if you're thinking about suicide?"
"Are you thinking about killing yourself?"

16

How to Persuade Someone to Stay Alive

Listen to the problem
Suicide is the problem, it's the solution
Do not rush to judgement
Offer hope in any way

17

Top 3 Referral Methods

1. Take the person directly to someone who can help
2. Getting a commitment from them to accept help, then make arrangements to get that help
3. Give referral information & try to get a good faith commitment not attempt or complete suicide

18

Big Four Risk Factors for Suicide

Past suicide attempt
Diagnosis of mood disorder
Increasing use/abuse of alcohol or drugs
History of self-harm

19

Suicide Signs Specific to Adolescents

Volatile mood swings
Sudden change in personality
Indications they are in unhealthy, destructive, or abusive relationships
Sudden deterioration in hygiene
Self-mutilation
Fixation with death
Eating disorders
Gender identity issues
Depression

20

Suicide Signs Specific to the Elderly

Stockpiling medications
Purchasing a gun
Giving away money or possessions
Sense of urgency to settle estate or finalize will
Taken sudden interest or loss of interest in religion
Failure to care for themselves in terms of ADLs
Withdrawing from relationships
Failure to thrive
Medical appointments for vague symptoms
Chronic issues of pain management
Undiagnosed depression

21

What medical conditions need to be screened for in the elderly before a diagnosis of depression is made?

Alzheimer's
Thyroid disorders
MS
MI
Stroke
Parkinson's
CA
DM
Hormonal imbalances
Vitamin B12 deficiency
Electrolyte imbalances
Dehydration
Viral infections

22

Which medications can lead to symptoms of depression in the elderly?

BP medications
Arthritis medication
Hormones
Steroids
Depakote, Lyrica, & Neurontin
Chantix
Singulair
Accutane
SSRI's

23

Parts of Suicide Inquiry

Thoughts of suicide
Plan
Intent
Access to lethal means

24

Important Information for Thoughts of Suicide

Duration
Frequency
Intensity

25

Important Information for the Patient's Plan for Suicide

Get specifics
Higher risk level: lethal, detailed, & specific plan

26

Suicide Inquiry: Intent

Lethal vs. self-injurious
Reasons to die vs. reasons to live
Mental status exam

27

Suicide Inquiry: Access to Lethal Means

Determine if the patient has access to the means mentioned in their plan or other lethal means

28

Protective Factors for Suicide

Clinical care for mental, physical, & substance abuse disorders
Clinical interventions & support for help seeking
Restricted accès to lethal means
Family & community support
Support from medical, mental health, & substance abuse relationships
Problem solving, conflict resolution, & non-violent handling of dispute skills
Cultural & religious beliefs

29

PCP Intervention for Suicidal Patients

Encourage a support network: supportive individuals & contact information
Practice coping strategies: minimize trigger items

30

Define Suicide Safety Plan

Stepwise plan to help the patient with recognizing the warning signs that a crisis is approaching and identifying coping strategies to soothe their emotions