Suicide Chapter 18

A behavior…not a diagnosis or disorder

Statistics – United States 30,000 successful suicides

per year

3rd leading cause of death for 15-24 yr olds

Women attempt more than men

Men are more successful than women (70% vs 30%)

Rates Highest among white males – across all ages

Geographic Distribution Higher rates

further you move west

Mountain states called the “suicide belt”

Possible reasons why?

Methods of Suicide Successful

• Women – “Poison” Overdose

• Men - Violence

Unsuccessful• Men and

women – “Poison” Overdose

High Risk Factors Marital Status – Single, Divorced Gender – Male Race – White Age – Positive correlation Religion – Protestant/Jewish SES – Highest and Lowest Race – Caucasian Co-Morbidity

• MH D/O• Substance Abuse• Insomnia• Family Hx of SUicide

Theories Psychological

• Anger – self hatred• Hopelessness – no point in living• Desperation - helplessness• Violence - Aggressive personality• Shame – Avoid public humiliation• Developmental Stressor – Rejection, Finances

Sociological• Egoistic- Isolated• Altruistic – Sacrifice for the group• Anomic – event that cause alienation

Biological• Genetics• Neurochemical – Lack of serotonin

Nursing Process - Assessment Demographics

• High Risk Factors

Presenting symptoms/DX• Psychiatric Conditions; Chronic Medical Illness

Ideations• Plan? Means? Priors? Hints?

Support Systems

Leading Events/Factors• Crisis combined w/MH D/O• Increased vulnerability

Family Hx

Coping Mechanisms

Nursing Process Diagnosis

• Risk for Suicide• Violence – Self Directed• Hopelessness• Ineffective Coping

Outcomes• No physical Harm to self• Realistic self-growth goals• Expresses hope• Demonstrates effective coping

Nursing Process – Inpatient Implementation

Therapeutic Communication – Interview data

Safe Environment Contract Close Observation Medications Examine Stressors and Coping Talk Therapy Positive Reinforcement Resources

Nursing ProcessOutpatient Implementation

Supervision Contracts Safe Environment Daily Appointments Problem Solving – Crisis Resolution Highlight successes Medications

Nursing ProcessFamily Interventions - Attempts

Take this seriously/Do not hide Share feelings of love, care concern,

desire to help Avoid anger, judgment, provokation Listen Be present Partner with seeking professional help Safe environment Resources – pg 274 - Numerous

• 1-800-SUICIDE

Family Interventions Suicide Victims Transcends the immediate loss Feelings of guilt and responsibility Encourage verbalization – share

memories Non-Judgmental – no blame/accusations Reality orientation – gently discuss

disturbed thought process of the deceased

Acknowledge the disorganization this causes and direct towards solutions

Resources