T/F? Individuals with mental illness who own a gun are more likely to use it for suicide vs homicide.
True
T/F? Half of suicides in 2019 were completed with a firearm
True
Name 3 particularly high risk populations for suicide
- veterans
- transgender
- older adult
Suicide is the ______ leading cause of death by 10-34 year olds and ______ leading cause of death among 34-54 year olds.
2nd; 4th
T/F? Most suicides are related to psychiatric disease
True
Diagnoses associated with heightened suicide risk
Top 3:
1. depression
2. substance use disorders
3. psychosis
Other: anxiety, personality, eating, trauma, organized mental disorders. TBI.
4 components of negligence
duty
breach of duty
direct causation
damages
foreseeability (r/t suicide risk assessment)
Examination in malpractice of whether the treating professional had sufficient information or should have acquired such information, so as to make a reasonable judgment
strategies to reduce bad legal outcomes r/t death by suicide
- Clear documentation showing reasoning for decisions
- clear informed consent
- documentation of patient capacity, ability to seek help
- Good malpractice coverage
Cognitive features that increase suicide risk
Loss of executive function
Tunnel vision
Polarized thinking
closed-mindedness
Demographic features that increase suicide risk
-male
-Widowed, divorced, single (esp for men)
-Elderly
-Adolescent & young age
-White
-Gay, lesbian, bisexual
Ethnic groups with highest rates of suicide
white & non-hispanic native american
cultural and religious factors that increase suicide risk
-The role of suicide, death, higher powers
- Role of shame
- Mechanism of coping as accepted/not
- Emotional expressiveness
Pre-disposing risk factors of suicide
poor self esteem
exposure to suicide behavior
impulsivity
substance dependence
depression
hopelessness, helplessness, worthlessness
Precipitating risk factors of suicide
Recent loss
anniversary reaction
availability of weapon
acute disappointment
Why ask someone “when did you obtain your gun”?
Suicide risk 57X higher within first week of gun purchase
tier 1 firearm questions (general inquiry)
- ownership
- access
- storage
- ammunition storage
- social support networs to assist with firearms
tier 2 firearm questions
- acculturation with guns
- time spent with gun
- violent fantasies associated with gun
- Psychodynamic attachment to gun (will taking gun cause more distress?)
- Hobby/recreational or other intentionality
- Peer/family views
Protective factors
Effective clinical care
easy access to a variety of interventions & support
Connectedness (fam & community)
Support from ongoing medical and mental health care relationships
Skills in problem solving, conflict resolution, nonviolent dispute management
Cultural and religious beliefs that discourage suicide & support self preservation
What does SAFE-T stand for?
Suicide Assessment Five-Step Evaluation and Triage
What are the 5 steps of SAFE-T?
- identify risk factors (modifiable & fixed)
- Identify protective factors (which can be enhanced?)
- Conduct suicide inquiry
- Determine risk level/intervention
- Document
What is the meaning of AIM associated with the Zero suicide effort?
Aim
Intervene
Monitor
Key variables to “Stop a Suicide”?
- Suicide intent
- Access to lethal means
- Motivation for suicide
- Purpose to go on living
- Quality of relationship with treater
- Family history of suicide
