OVERVIEW Definitions and Statistics Myths and Facts About Suicide The Suicidal Process Precipitating and Risk Factors Warning Signs Suicide Intervention (ACE Model) Social Networks CF Policy Self Care Resources
Suicidal Ideation Persistent, repetitive, and preoccupying thoughts about suicide leading up to a suicide or suicide attempt. Suicide Attempt A deliberate, life-threatening act against oneself with the intention of causing their own death. Suicide A deliberate act against oneself that results in death. DEFINITIONS
CF suicide rate (males) has been validated to 2008 and the four year average is 17.8/100 000. Standardized suicide mortality rate to 2004 comparing the male CF to the general Canadian male population of the same age is approximately 80% The CF suicide rate is 20% lower than the Canadian population. CF Suicide Statistics
“Suicide comes without warning!” MYTH or FACT? MYTH
Common Myths & Facts About Suicide “ People considering suicide really want to die.” MYTH or FACT? MYTH
Common Myths & Facts About Suicide “Suicide is an act of courage or cowardice.” MYTH or FACT? MYTH
Common Myths & Facts About Suicide “Once a person is suicidal, they will never change their mind.” MYTH or FACT? MYTH
Common Myths & Facts About Suicide “Someone who has attempted suicide doesn’t really want to die; they’re just trying to get attention.” MYTH or FACT? MYTH
Common Myths & Facts About Suicide “Improvement following a suicide attempt or intervention signifies that the risk has passed." MYTH or FACT? MYTH
Common Myths & Facts About Suicide “Talking to someone about their suicidal feelings will cause them to attempt or complete suicide." MYTH or FACT? MYTH
Common Myths & Facts About Suicide "Most people who are suicidal suffer from depression, mental health or addiction problems." MYTH or FACT? FACT
Understand and increase awareness. How Can You Help?
Divorce or relationship failure Grieving / loss of someone close Academic or professional failure Addictions / substance misuse Physical, emotional abuse/family violence Financial problems Legal problems Precipitating Events
Trouble sleeping Irritability Anger, Impatience Nervousness, anxiety Muscle tension Headaches Low energy Poor concentration Negative attitude Forgetfulness Procrastination Often late for work Increased swearing Decreased productivity Mental Health Continuum Model HealthyReactingInjured Ill Noticeable fatigue Angry outbursts Panic attacks Forgetting important things Impaired decision making Taking risks Inappropriate aggression Insubordination Absenteeism Increased accidental injuries Severe memory lapses Cannot concentrate Avoiding or withdrawing Regular panic attacks Loss of control Cannot perform duties Indications of suicidal thoughts, intentions Legal charges Significant change in behaviour Calm & steady Confident in self & others Getting job done In control physically, mentally, emotionally Behaving ethically and morally Sense of humour Fit, fed, rested Relaxing & recreating Socially active
Risk Factors (Stats Can, Langlois,Morrison, 2002) VARY WITH AGE, GENDER Depression or other mental health concerns Alcohol and/or other drug use Previous suicide attempts Family history of suicide behaviour Isolation or withdrawal Impulsivity Suicidal ideation
Soon, I’ll get some peace. Die now or later… what’s the difference? I wrote my will. I’m a loser…I’m useless. You’ll be better off without me. Thanks for everything you’ve done for me. I won’t be needing these things anymore. Indirect Messages
I want to end it all. I’m going to kill myself. Life doesn’t mean anything to me anymore. I’d be better off dead. I just can’t take it anymore. I’ll never be able to get out of this. All of my problems will end soon. Direct Messages
Trouble sleeping Lack of appetite General malaise Extreme fatigue Shortness of breath Low or monotone voice Physical Signs
Changes in behaviour and/or personality. Isolation, withdrawal, sadness. Abuse of alcohol, medications or other drugs. Reduced job performance or academic results. Difficulty making decisions, lack of focus/concentration. Neglect of personal appearance or hygiene. Psychological & Behavioural Signs
As someone outside the spiral, we see the support… Someone who is suicidal, sees this… 1. Person at risk seeks solutions… 2. Flash 3. Ideation 4. Rumination 5. Crystallization THE SUICIDAL PROCESS
Ask if the person is thinking about suicide: ask how, where and when The more detailed the plan, the faster you need to act. Listen… let the person know that you care and understand. Keep safe, disable plan (intervene). Encourage the person to get help… link to resources Go with them if they need support. Follow up. Get the information and support you need in order to be better equipped to help. What To Do / Intervention
ACE US Army Center for Health Promotion and Preventative Medicine Ask –Ask about suicidal thoughts. Know warning signs and if present, ask if person is thinking about killing themselves. Care –Understand that person may be in pain. –Active listening may cause some relief. listen for what, where, and when explore ambivalence –Take action by removing any lethal means. Escort –Take person to someone who can help. helping professionals (see references for complete list) chain of command identify support systems
Pass judgment. Make false promises. Challenge the person to do it. Minimize their feelings. Give advice or try to solve their problems. Try to physically intervene What NOT To Do
Confidentiality could risk the possibility of prevention or intervention. The responsibility of maintaining confidentiality could be overwhelming for the person helping/assisting. Confidentiality
INJURED Anger / Conflict Not Performing Injuries Insubordination INJURED Anger / Conflict Not Performing Injuries Insubordination ILL Significant Changes Not Functioning Suicidal Thoughts ILL Significant Changes Not Functioning Suicidal Thoughts REACTING Absenteeism Negative Attitude Swearing Impatience REACTING Absenteeism Negative Attitude Swearing Impatience HEALTHY Performing Well Constructive Input Appropriate Behaviour HEALTHY Performing Well Constructive Input Appropriate Behaviour What Can YOU do? Get to know personnel. Foster healthy environment. Set example. Watch for behaviour changes. Advocate. Get to know personnel. Foster healthy environment. Set example. Watch for behaviour changes. Advocate. Minimize stressors. Identify unhealthy situations. Support. Intervene – Consult – Identify Resources - Refer Minimize stressors. Identify unhealthy situations. Support. Intervene – Consult – Identify Resources - Refer Involve resources. Follow MELs. Maintain contact & ensure support. Deal with unacceptable behaviour. Minimize rumours. Involve resources. Follow MELs. Maintain contact & ensure support. Deal with unacceptable behaviour. Minimize rumours. Maintain contact. Ensure adequate resources / support. Follow Medical Employment Limitations Include member in Unit activities. Maintain contact. Ensure adequate resources / support. Follow Medical Employment Limitations Include member in Unit activities. You can…
INJURED Anger / Conflict Not Performing Injuries Insubordination INJURED Anger / Conflict Not Performing Injuries Insubordination ILL Significant Changes Not Functioning Suicidal Thoughts ILL Significant Changes Not Functioning Suicidal Thoughts REACTING Absenteeism Negative Attitude Swearing Impatience REACTING Absenteeism Negative Attitude Swearing Impatience HEALTHY Performing Well Constructive Input Appropriate Behaviour HEALTHY Performing Well Constructive Input Appropriate Behaviour Key Role of Leaders Foster healthy climate. Reduce barriers to help-seeking. Deal with performance issues promptly. Identify and resolve problems early. Demonstrate genuine concern. Example of personal accountability. Foster healthy climate. Reduce barriers to help-seeking. Deal with performance issues promptly. Identify and resolve problems early. Demonstrate genuine concern. Example of personal accountability. Involve members in social support. Follow employment limitations. Maintain respectful contact. Seek consultation as needed. Respect confidentiality. Involve members in social support. Follow employment limitations. Maintain respectful contact. Seek consultation as needed. Respect confidentiality.
Social Network FAMILY FRIEND HELP LINE CARING PERSON TRAINIED IN SUICIDE AWARENESS
911 Padres Local Police Military Police Hospitals / Medical Clinics Mental Health Services Health Promotion Member Assistance Program (MAP) 1-800-268-7708 Employee Assistance Program (EAP) 1-800-387-4765 Family Resource Center (MFRC) Health Units Resources
It is important to reduce the effects of an intervention experience. –self reflection and self monitoring of thoughts and feelings after the event writing/journaling, talking and sharing –basic self care principles enough sleep/rest, good nutrition, and physical activity participate in activities you enjoy, have fun, humour spiritual renewal take a break from routine connect with nature Self Care
CONCLUSION Do not judge Listen, understand, aid. Be direct: ASK the question. If ‘yes’ then ask how / when / where? Consider safety… yours and theirs. Know your personal limits. Know and utilize available resources.
Suicide Awareness & Intervention Workshop QUESTIONS or COMMENTS? Suicide Awareness & Intervention Workshop QUESTIONS or COMMENTS?
Your health - Our mission Votre santé - Notre mission HLIS Data Social Wellness
Reasons for Seeking Help from a Mental Health Professional
Relationship Satisfaction, Family Violence and Abuse 82% of survey respondents were currently in a relationship. Of those, 91% were either extremely, very, or somewhat satisfied with this relationship. 15% of CF personnel who responded had experienced at least one type of physical or sexual abuse in their current relationship. Males reported being on the receiving end of this abuse more commonly than females while males and females were equally reported to be perpetrators. A history of emotional or financial abuse was more common with 19% of CF personnel stating they were responsible and 25% stating their spouse was responsible.
Anger Management: HLIS 2008/9 78% of CF personnel rarely or never found themselves struggling with levels of anger that interfered with their ability to do their job or with personal relationships. However, 18% reported that anger sometimes and 4% reported that anger often created this problem.
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