1. Suicidal Thoughts and Behaviors
Chapter 20
Suicidal Thoughts and Behaviors

2. Suicide or completed suicide
The act of intentionally ending ones own life and opting for nonexistence
Act of purposeful self destruction by taking ones own life
Suicide attempt: includes all willful, self-inflicted, life threatening attempts that have not led to death
Suicidal ideation means a person is thinking of self harm
Always take a person seriously regarding suicidal ideation
Physician assisted suicide
Terminally ill

3. Prevalence and comorbidity
Suicide is 11th leading cause of death in US
3rd leading cause of death in adolescents & young adults
Majority of completed suicides have depression, alcohol/substance abuse
Risk of suicide is 20x higher in MDD

4. Theories Freud developed the first psychiatric theory of suicide
Menninger suggested that all suicides experience 3 emotions -revenge, depression and guilt
Shneidman suggested that victims of suicide suffer psychological pain

5. Risk factors for suicide
Poor problem solvers, troubled emotional lives (depression, anger, guilt, boredom)
Biological
Cluster in families; family history is pertinent
Cultural and Societal
Loss, lack of social supports, negative life events, and severe life stress
Psychological
Psychosis-high risk suicide
Plan, previous attempt, hx depression, alcohol or substance abuse, impulsiveness, recent loss, hopelessness, family history
Age: adolescents, young adults, older adults
Gender: men at greater risk for suicide

6. Cultural considerations
European Americans: 2x suicide rate of minority groups
Native Americans equal to suicide rate of European Americans
African American men commit suicide more often than women
Asian Americans suicide risk increase with age

7. Application of nursing process

8. Application of nursing process
Diagnosis
Risk for suicide
Outcomes and Identification
Interventions to optimize factors to minimize self destructive events
Work with pts to explore alternatives, problem solve
Implementation
Treating depression, medication, family/community support, restrict lethal methods, screen for weapons
Communication Guidelines/Psychotherapy
Postvention: Intervention for family and friends of person who committed suicide