Suicide

1. Suicide Josh, Andrew & Stephanie 7/1/09

2. What it is... The act or an instance of taking one's own life voluntarily and intentionally. Direct suicide: When one has the intention of causing ones own death. Indirect suicide: person intentionally sets out on a fatal course such as entering the military service with the intention of getting killed in combat.

3. Cont… • Submissive deaths: People simply let themselves die by not caring for themselves. • Suicidal Erosion: Indirect form of suicide by engaging in high-risk activities such as drinking, smoking or other drug abuse.

4. Who’s at Risk? • White males • Geographically isolated • Chemically dependent • Cognitive disorders • Divorced, Separated • Family history • Teenagers • Extended periods of anxiety/crisis

5. Genetic/Heriditary • There is possible link to an abnormality of the genomes in the 2nd chromosome pair. • Has also been linked to bipolar disorder. • Family history of suicide is said to increase attempts by x6. • Alcoholism and depression can be hereditarily acquired thus increasing probability.

6. Suicide Facts • Beltrami has the highest suicide rate in MN. • Second leading cause of death for 15 – 34 Yrs • Third leading cause of death for 10 – 14 Yrs. • Fourth leading cause of death for 35 – 54 Yrs. • 4/5 teens knew a friends intentions but chose not to tell an adult.

7. Beltrami County Suicide Facts • Beltrami County has an average of 19 suicides per 100,000 people, compared to the statewide average of 10 per 100,000. • Youth suicide rates are 21 per 100,000 people. • Native Americans have the highest rate at 30 per 100,000 people. • They are not sure why we have such a high rate, but many believe it ranges from high alcohol and drug usage to the lack of mental health services.

8. Suicide Continued • On average one successful suicide occurs every 17 minutes while an attempt occurs once every 40 seconds in the US. • Second leading cause of death among college students • 58% of all suicides are accomplished by firearms. • Between 1950-2000 the suicide rate in teens has tripled.

10. Warning signs • Statements about hopelessness, helplessness, or worthlessness • Giving away prized possessions. • Substance Abuse. • Visiting or calling people one cares about. • Recently discharged pt from psychiatric hospital. • End of a romantic relationship, loss of close friend, and loneliness.

11. Signs and symptoms • Talking about Suicide • Withdrawing from Societal Contact and Wanting to be Left Alone • Dramatic Mood Swings • Preoccupation with Death, Dying, or Violence • Increased use of Alcohol and/or Drugs • Change in Behavior (lack of concentration in work, school or other activities). • Change in Eating Habits (loss of appetite, increased eating, weight loss).

12. Myths • Suicide Myth • You should never ask people who are suicidal person if they are thinking about suicide or if they have thought about a method, because just talking about it will give them the idea. • Suicide Fact • Asking people if they are thinking about suicide does not give them the idea for suicide. And it is important to talk about suicide with people who are suicidal because you will learn more about their mindset and intentions, and allow them to diffuse some of the tension that is causing their suicidal feelings. • Suicide Myth • Most suicide victims leave a note behind. • Suicide Fact • Only 12% to 20% of victims leave a note behind and this may depend on culture, suicide method, and ethnicity. • Suicide Myth • People who attempt suicide and survive will not attempt suicide again. • Suicide Fact • People who attempt suicide and survive will oftentimes make additional attempts.thod or ethnicity.

13. Interventions • Approach person in calm matter and question the person about feelings or intentions. This lets the person know you are listening and care about them. • Group Therapy can be helpful to some. • Anti-depressants can help with controlling depression which can increase the incidence of suicide. • Listen

14. Short term prognosis • If successful, mortality rate is 100% • Treat symptoms after attempted suicide such as wounds, poisoning, and psychological disorders. • Find underlying cause and plan accordingly. • If chemically dependent seek out help with rehab. • Establish therapeutic relationship with someone that they can use as a crutch.

15. Long Term • Suicidal relapse can happen when a patient stops taking medication because of side effects or because they feel “cured”. • Recovery is constant. • Optimistic thinking and giving compliments to oneself are extremely helpful in maintaining a healthy outlook on life.

16. Psychiatric TX • As with all treatments, must be individualized for the person. • Therapeutic patient psychiatrist relationship until patient is no longer a high risk followed by check ups as needed. • Treat the underlying cause such as depression, anxiety, Post Traumatic Stress Disorder.

17. Medical Tx • Must be individualized for the patient other wise adverse effects may arise. • Lithium, Eskalith, Lithobid can help treat psychological disorders which can increase the incidence of suicide. • St John’s Wart, Kava Kava, and Omega fatty acids are herbal and natural which are considered to be safer, and have been proven effective in disease conditions. • Maintain therapeutic dosage to reduce suicidal behavior. • May take a few months until medication is therapeutic.

18. Prevention • School intervention programs • Psychotropic Medications • Counseling/Group therapy • Outpatient Tx plan. • Cognitive behavior therapy • Catharsis • Remove all potentially harmful substances or items from their household.

19. Prevention cont… • SAVE – One of the nation’s first organizations dedicated to the prevention of Suicide • Co-founding member of the National Council for Suicide Prevention • One of the leading non-profit organizations dedicated to the prevention of suicide.

20. Why it’s Psychological • Suicide is an in important topic in nursing because it is important to treat the patients mind as well as their physical symptoms. • Depression, Bipolar, and anxiety are almost always an underlying condition of most suicides and all of these are psychological disorders. • Chemical dependence is also a psychological disorder that often accompanies suicides.

21. Questions • T or F Talking to someone will make them go out and commit suicide? • What percent of suicide victims leave a note? • A. 30 to 50% • B. 12 to 20% • C. 5 to 10% • D. 60 to 80% • T or F Beltrami County has the highest suicide rate in the state.

22. References • Saxena, S (2007). World Suicide Prevention Day. Retrieved June 18, 2009, Web site: http://www.who.int/mediacentre/news/statements/2007/s16/en/index.html • Benson, L (2007). Beltrami Suicide Rate Triggers Health Department Investigation. Retreieved June 2,2009, Web site: http://minnesota .publicradio.org/display/web/2007/17/suicide stats/.html • Neeb, K (2006). Fundamentals of Mental Health Nursing. Philadelphia, PA: F.A Davis Company. • (2003). The Merck Manual of Medical Information. Rahway, NJ: The Merck Publishing Group • http://minnesota.publicradio.org/display/web/2007/09/17/suicidestats/ • http://en.wikipedia.org/wiki/Suicide_note • http://www.suicide.org/suicide-myths.html • Craig, Grace S. and Dunn, Wendy L. Understanding Human Development, Pearson Education, Inc. 2007