Suicidal Assessment
Transcript of Suicidal Assessment
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SUICIDALASSESSMENT
(sad persons)
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SUICIDE
IS KILLING ONESELF.
The act constitutes a
person willingly, perhaps
ambivalently, taking his orher own life.
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SUICIDE ASSESSMENTS: SEX Men are more likely to commit suicide than women.
A: AGE The ages which are most dangerous for suicide vary over time
should consult current statistics. As this is being written in 2006
individuals 15-24 have an elevated risk. Suicide is the third leadingcause of death in this age group.
Males over age 75 are also known to be at high risk. Current
demographics suggest that women in the 45 to 54 age group are
highest, but females in older or younger age ranges are not that
different. After age 65 individuals as a whole have an attempttovcompleted suicide rate of about 2:1. Up to age 65, it is about a 7:1
ratio.
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SUICIDE ASSESSMENTD: Depression. The suicide rate for those who are clinically depressed is about 20
times greater than for the general population. Hopelessness is one
aspect of depression that has a close tie to suicide. These two issues,
depression and hopelessness, are the strongest predictors of wishes
for a hastened death.
P: Prior History. Roughly 80% of completed suicides were preceded by a prior
attempt.
E: Ethanol abuse. Alcohol and/or drug abuse increase risk.
R: Rational
thinking loss.
Psychosis (I heard a voice saying I should kill myself) increases risk.
Some estimates suggest that 20-40% of schizophrenics make an
attempt at some point, and the risk is highest early on in the illness.
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SUICIDE ASSESSMENTS: Support SystemLoss.
Loss of support can vary tremendously. With kids andadolescents it can be the break up of their first puppy love which
they can take very seriously even though others like parents may
view it as a trivial event.
Other lost relationships for adolescents can include parents
divorcing and remarrying someone else. Even a parent who isdivorced or separated and living with a new person can be a trigger
for adolescent suicide. The death of a relative, such as grandparents,
can be another trigger for kids.
Loss of a spouse can be devastating to some. Loss of a parent
within the past 35 years increases risk of suicide. Among olderindividuals, men who are widowed, and women who are divorced or
separated are at increased risk
O: Organized Plan. This speaks for itself. Having a method in mind creates more risk.
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SUICIDE ASSESSMENTN: No SignificantOther.
See S above.
S: Sickness. Terminal illness, such as cancer and AIDS, also carries with it a 20 fold
increase in risk of suicide compared to the general population.
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SUICIDE ASSESSMENT
No real problems, keep watch
SCORE
3 4
0 2
5 6
Consider hospitalization involuntary or voluntary,depending on your level of assurance patient with
return for another session
Send home, but check frequently
RISK
definitely hospitalize involuntarily or voluntarily7 10
SCORING SYSTEM
1 point for each positive answer on the table.
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SUICIDE ASSESSMENT
SAD PERSONS: a mnemonic for assessing suicide risk
S ex (male)
A ge (elderly or adolescent)D epression
P revious suicide attempts
E thanol abuse
R ational thinking loss (psychosis)
S ocial supports lacking
O rganized plan to commit suicide
N o spouse (divorced > widowed > single)
S ickness (physical illness)
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SIGNS OF DEPRESSION
Sleep, energy, weight, or appetite changes
Decreased interest in sex and other pleasurable
activities
Feelings of helplessness and hopelessness
Social isolation and withdrawal from others
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SUICIDE RISK FACTORS
In addition to untreated depression, other suicide risk factors
include:
mood disorder
chronic anxiety
previous suicide attempts
genetics family history of suicide or psychiatric
conditionsconduct disorder
child abuse
sexual assault
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stressful events, including relationship breakups, family problems, etc.
drug and alcohol abuse
eating disorders
being bullied
dropping out of school
taking certain medications, including ANTIDEPRESSANTS, STRATTERA
(atomoxetine), a medication for ADHD, and ACCUTANE (isotretinoin),
which is used to treat teens with severe nodulocystic acne, and
ANTISEIZUREDRUGS, such as Tegretol (carbamazepine), Depakoke
(valproate), and Lamictal (lamotrigine)
Suicide is also more common in bisexual and homosexual teens.
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Suicide Warning Signs
According to the American Association of Suicidology, the warning signs
of suicide can include:
Having thoughts of committing suicide, threatening to hurt himself,
looking for a way to hurt himself, writing about dying, and other types of
suicidal ideation
Increased substance abuse, including abuse of alcohol and drugs
Feelings of purposelessness or that they have no reason to liveAnxiety symptoms
Feeling trapped, like there is no way out of current situations or problems
Feelings of hopelessness
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A withdrawal from friends and family and usual activities
Feeling uncontrolled anger and rage or wanting revenge against
someone
Acting reckless and impulsive
Having dramatic mood changes
If you think that your teen has any of the warning signs for suicide,
don't ignore them. Trust your instincts and either try to get more
information or seek additional help.
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SUICIDE PREVENTION
Recognizing the risk factors and warning signs for suicide
Seeking professional help
Making sure that GUNS and medications aren't easily available in your
home if your teen might be suicidal
Getting teens professional help if they have depression and/or anxiety,
which are often thought to be the biggest risk factors for suicide
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Questions to Ask
Do you have thoughts of suicide?
Are they related to current stressors going on in your life, or have you had
such thoughts before?
Do you have a plan? Tell me.
If you died in your sleep, would that be all right with you?
Ask if they have access to the components of their plan, like a gun, pills,
etc
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LEVEL OF RISK
None - no suicidal ideation
Mild - some ideation, no plan
Mod - ideation, vague plan, low on lethality, wouldSevere - ideation, plan specific and lethal, wouldn't do it
Extreme - ideation, plan specific and lethal, will do it
Highest risk group has suicidal ideation (thoughts of killing self), a plan
(any plan so long as it is definite and detailed is high risk), high lethality(guns and walking in front of busses are more serious than overdosing on
Tylenol and slashing wrists), few inhibitors (few reasons not to kill self),
low self-control (especially drinking or using drugs - can decide not to kill
self but fail to act to reverse events and accidentally kill themselves)
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SUICIDAL ASSESSMENT
FIRST, remember to do three things:
1. CONSULT2.DOCUMENT
3. EVALUATE THE CLIENTS RISK
Empathize with the client Make a No-Suicide Contract
Family Intervention
Hospitalization
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SUICIDE is never thesolution. Eternal life
comes after physicaldeath. where would u
go?