Suicidal Assessment

8/8/2019 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.


8/18

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

SUICIDE ASSESSMENT


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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

SUICIDE ASSESSMENT


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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.

SUICIDE ASSESSMENT


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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

SUICIDE ASSESSMENT


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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.

SUICIDE ASSESSMENT


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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

SUICIDE ASSESSMENT


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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

SUICIDE ASSESSMENT


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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)

SUICIDE ASSESSMENT


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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

SUICIDE ASSESSMENT


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SUICIDE is never thesolution. Eternal life

comes after physicaldeath. where would u

go?

Documents

Suicidal Assessment