Suicide

Question 1

Suicide is the most common cause of death in which cohort of the population?

Answer 1

Men under the age of 45

Question 2

How many more times common is suicide in men in comparison to women?

Answer 2

three

Question 3

What are the most common methods of suicide?

Answer 3

hanging, strangulation, suffocation and poisoning (mainly from overdose of medication  most commonly paracetamol, heroin and alcohol)

Question 4

Risk factors for suicide?

Answer 4

• Previous suicide attempt or previous self-harm
• Male gender (3x more common than women)
• Age – currently highest aged 40-44
• Current mental disorder or previous psychiatric treatment
• Unemployment, recent loss of job
• Homelessness
• Alcohol or drug abuse
• Physically disabling or painful illness, including chronic pain
• Low socio-economic status
• Certain professions  higher in vets, doctors, dentists
• Lack of social support/living alone
• Significant life events  bereavement, family breakdown
• Institutionalised  prison, army
• Bullying

Question 5

How many times higher is the risk for suite in patients with mental disorders than those without?

Answer 5

5-15 times higher

Question 6

What do you assess when assessing someone for attempted suicide?

Answer 6

The act itself
assess current intent and plans
risk factors
assess their needs (e.g. social, physical or psychological Sx)

Question 7

What questions do you ask about the act itself?

Answer 7

• How did they do it  what did they use?
• Why did they do it, what happened today
• Did they plan? Leave any notes? Wills?
• How do they feel now, do they feel regretful? Sad/Happy it didn’t work?

Question 8

What are you assessing with regards as to their current intent and plans with regards to suicide?

Answer 8

• Wish to be dead
• Feelings of hopelessness
• Regret/remorse over current/previous attempt
• Expectation bout outcome of self-harming behaviour or suicide attempt/threat
• Specific plans
• Lethality and frequency of plans or attempts
• Other self-harming behaviour
• Assess current suicidal intent/wishes
• Length of time the suicidal feelings have been present
• Plans for others after death  notes, changes to will, consequences

Question 9

what risk factors are assessed?

Answer 9

• Assessment of mental health
o Past psychiatric history
o Depressive and other psychiatric Sx
o Medication
o History of alcohol or illicit drug use
o Observation of verbal and non-verbal indicators of mental state
o Previous self-harm or suicide attempts
o Age, gender, social situation
o Relationships which may be supportive/protective or may pose a threat (abuse/neglect)
o Access to lethal methods e.g. anaesthetist, pharmacist
o Any protective factors?

Question 10

What needs are assessed?

Answer 10

• Social problems
• Untreated mental health disorders
• Physical symptoms and disorders
• Coping strategies
• Psychosocial and occupational functioning
• Personal and financial difficulties
• Needs of dependants

Question 11

What may be included in the mx plan for suicide attempt/suicidal?

Answer 11

• Prevent self-harm or suicide attempts
• Reduce level of injury from self-harming behaviour
• Improve QoL
• Improve social and occupational functioning
• Improve mental health conditions
• Improve physical symptoms
• TREAT CO-MORBID CONDITIONS

Question 12

What specific treatment options are available for suicidal patients?

Answer 12

Medication - SSRIs, alcohol detox, anxiety medication etc.
Counselling
Psychotherapy esp CBT
Follow up of pt at regular intervals