Depression and Suicide All Rights reserved Austin Community College

Suicide Suicidal Ideations- Thoughts Suicidal Ideations- Thoughts Suicidal threats-States intent Suicidal threats-States intent Suicidal gesture- Suicidal gesture- suicidal attempt-Serious method with intent suicidal attempt-Serious method with intent

Incidents of Suicide Ninth leading cause of death in US Ninth leading cause of death in US Third leading cause of death in the age group Third leading cause of death in the age group Seventy three percent of suicides are white men Seventy three percent of suicides are white men Suicides, not homicide, is the leading cause of gun death-57% Suicides, not homicide, is the leading cause of gun death-57% 10-19yr olds use a gun to kill themselves every six hours 10-19yr olds use a gun to kill themselves every six hours

Adolescents and Suicide 15 to 19 year olds suicide rates have quadrupled in this decade 15 to 19 year olds suicide rates have quadrupled in this decade Theory is that teens feeling alienated and isolated is factor in suicide Theory is that teens feeling alienated and isolated is factor in suicide Access to guns adds to problems in this population Access to guns adds to problems in this population tend to be impulsive tend to be impulsive Can have “Copy cat” aspect to it Can have “Copy cat” aspect to it

Issues in Suicide Suicidal patients are ambivalent Suicidal patients are ambivalent Themes are; loss hopelessness, loneliness, psychic pain, abandonment Themes are; loss hopelessness, loneliness, psychic pain, abandonment Escape, manipulation, retaliation, reunion,loss of self esteem, redemption Escape, manipulation, retaliation, reunion,loss of self esteem, redemption Medical illness Medical illness

Risk factors for suicide Elderly single men with health problems Elderly single men with health problems Unemployed professional workers Unemployed professional workers Previous attempts Previous attempts Women make more attempts; males more lethal Women make more attempts; males more lethal Adolescents Adolescents Certain Cultures Certain Cultures

Assessment of Suicidal Patients Plan; the more developed, greater risk Plan; the more developed, greater risk Method—Lethality and availability Method—Lethality and availability Rescue—does person try to block Rescue—does person try to block Can patient carry out plan Can patient carry out plan Pts. At greater risk as depression lifts Pts. At greater risk as depression lifts

Suicide and Mental Illness Are psychotic people more at risk than depressed? Are psychotic people more at risk than depressed? Only “Crazy”people commit suicide? Only “Crazy”people commit suicide? 90% have Diagnosable mental 90% have Diagnosable mental conditions conditions Substance abuse, bipolar depression, Major Depression, Schizophrenia

Assessing Suicide Potential Does the Pt. have a plan? Lethality Does the Pt. have a plan? Lethality History of previous attempts History of previous attempts Lives alone or feels alienated Lives alone or feels alienated White males over age 50 most lethal group. Females make more attempts White males over age 50 most lethal group. Females make more attempts Recent loss and excessive guilt Recent loss and excessive guilt Poor physical health Poor physical health

Cont. Suicide Assessment Agitated depression or when it lifts Agitated depression or when it lifts Drinking and drugging Drinking and drugging Often writes a suicide note Often writes a suicide note Giving away their belongings Giving away their belongings Depression and anger Depression and anger Having schizophrenia Having schizophrenia

Treatment Hospitalization: Locked area, PICU Hospitalization: Locked area, PICU Assess: ask pt. if they are suicidal Assess: ask pt. if they are suicidal Remove harmful objects from pts. Remove harmful objects from pts. 1-1 suicide watch 1-1 suicide watch Try to “make a connection” establish rapport Try to “make a connection” establish rapport Anti-depressant medication Anti-depressant medication Have pt. sign a “No-harm Contract” Have pt. sign a “No-harm Contract”

Nursing diagnosis High Risk for Violence: directed at self High Risk for Violence: directed at self Self esteem disturbance Self esteem disturbance Hopelessness Hopelessness