1. Suicide
    A significant public health problem in the US
  2. Risk Factors
    • Psychiatric D/O
    • ETOH or substance abuse D/O
    • Male gender
    • Increasing Age
    • Race
    • Religion
    • Marriage
    • Profession
    • Physical Health
  3. Biological Factors
    • Suicidal Behavior tends to run in families
    • Low serotonin levels are r/t depressed mood
  4. Psychosocial Factors
    • Freud- Aggression turned inward
    • Menninger: Wish to kill, Wish to be killed, Wish to die
    • Aaron Beck- Central emotional factor is hopelessness
    • Recent theories- combination of suicidal fantasies and significant loss
  5. Cultural Factors
    • Protective Factors:
    • African Americans: Religion, role of the extended family
    • Hispanic Americans: Roman Catholic religion and importance of extended family
    • Asian Americans: Adherence to religions that tend to emphasize interdependence between the individual and society
  6. Societal Factors
    • Oregon's Death with Dignity Act: terminally ill pt allowed MD assisted suicide
    • Netherlands- Nonterminal cases of "lasting and unbearable" suffering
    • Belgium- Non terminal cases when suffering is constant and cannot be alleviated
    • Switzerland- Assissted suicide legal since 1918
  7. Assessment: Overt (Open) Statements
    • "I can't take it anymore."
    • "Life isn't worth living anymore."
    • "I wish I were dead."
    • "Everyone would be better off if I died."
  8. Assessment: Covert (Concealed) Statements
    • "It's okay, now. Soon everything will be fine."
    • "Things will never work out"
    • "I won't be a problem much longer."
    • "Nothing feels good to me anymore and probably never will."
    • "How can I give my body to medical science?"
  9. Assess: Lethality of Suicide Plan
    • Is there a specific plan with details?
    • How lethal is the proposed method?
    • Is there access to the planned method?
    • People with definite plans for time, place and means are at high risk.
  10. Assessment Tools: SAD PERSONS Scale: p 554
    • Uses 10 major risk factors to assess suicidal potential
    • 1. Sex (male)
    • 2. Age 25-44 or >65
    • 3. Depression
    • 4. Previous Attempt
    • 5. Ethanol Use
    • 6. Rational thinking loss
    • 7. Social support lacking or recent loss
    • 8, Organized plan
    • 9. No spouse
    • 10. Sickness
  11. Nursing Diagnosis
    • Risk for suicide
    • Ineffective Coping
    • Hopelessness
    • Powerlessness
    • Social Isolation
  12. Levels of Interventions
    • Primary: Activites that provide support, info, and education to prevent suicide (Beginning)
    • Secondary: Tx of the actual suicidal crisis. (Middle)
    • Tertiary: Interventions with the family and friends of a person who has committed suicide to reduce the traumatic aftereffects. (End)
  13. Basic Level Interventions
    • Milleu therapy with suicidal precautions
    • Counseling
    • Health teaching and Health Promotion
    • Case Management
    • Pharmacological Interventions
  14. Survivors of Completed Suicide: Post-Intervention
    • Surviving Friends and Family have overwhelming shame and guilt
    • Difficulties discussing the taboo subject of suicide
    • Staff: Group support essential as Tx team conducts a thorough postmortem assessment and review
Card Set
Mental Health Test 2, Suicide