Basics
Self inflicted death
Biggest predictor of suicide
Previous attempt
Behavioral
talking/writing about death, giving away possessions, withdrawal from others
What is the first step in suicide assessment?
Asking directly
Action performed for high risk patients
Never leave them alone
What is suicidal ideation?
Thinking of or planning suicide
Which MH condition has a 15-20x higher risk?
Bipolar disorder
Verbal
"You'd be better off without me"
"You'll miss me when I'm gone"
What is an important question to ask after asking directly?
"Do you have a plan?"
Important environmental intervention
Remove harmful objects
Attempt with intent but not fatal
Suicide attempt
Which neurotransmitter is decreased in suicide risk?
Serotonin
Emotional
Hopelessness, helplessness, feeling trapped
What tool is used for suicide assessment?
SAFE-T or Columbia Scale
What is the long term goal of care?
Improve coping and support system
Suicide is caused by this type of factor
What biological factors increase risk?
If a family member died by suicide
Mneumonic for suicide warning signs
IS PATH WARM
First line med for depression
SSRI
What should be done with planning care?
Involve patient (gives them control), determine their risk: low --> outpatient tx - high --> hospitalization
What is the updated terminology for suicide death?
Died by suicide NOT COMMITTED SUICIDE, BRI!
What are some personal/social factors that increase risk?
Substance use, bullying (esp in kids), hopelessness, feeling like death is the only way out, veteran
What does IS PATH WARM stand for?
I - ideation
S - substance use
P - purposelessness
A - anxiety
T - trapped feeling
H - hopeplessness
W - Withdrawal
A - Anger
R - recklessness
M - mood changed
Why is the risk for suicide increased after starting antidepressants?
Increased energy, they feel good, so they are more willing to follow through with plan
Be direct, nonjudgmental, every case is different and individualized
Nursing takeaways