Suicide Attempts
FACTS to REMEMBER:
 Suicide stems from depression and may be
viewed as a call for help
 Males: at greater risk (mostly successful)
Suicide Behavior Disorder- DSM 5
 conceptualized primarily as a specific
symptom of Major Depressive Disorder
(MDD) and Borderline Personality Disorder
(BPD), or as a possible negative
consequence of other psychiatric diagnoses
 more than 40,000 people are dying by
suicide each year in the United States
 Prevention efforts have proven difficult to
develop, possibly because no one risk factor
predicts suicide with high accuracy
Suicide Behavior Disorder-DSM 5
Diagnosis would require an individual to meet all
five of five of the following diagnostic criteria:
• Within the last 24 months, the individual has
made a suicide attempt.
• The act does not meet criteria for non-
suicidal self-injury (NSSI).
• The diagnosis is not applied to suicidal
ideation or to preparatory acts.
• The act was not initiated during a state of
delirium or confusion.
• The act was not undertaken solely for a
political or religious objective.
Suicide Behavior Disorder- DSM 5
• The criteria also explicitly define "suicide
attempt" as "a self-initiated sequence of
behaviors by an individual who, at the time
of initiation, expected that the set of actions
would lead to his or her own death"
Have you ever...
Wondered if there is life after death?
Wished you were someone else?
Wondered being someone else's child?
Wished you can just disappear from a situation?
Became curious if death could be painful?
Management:
a. Treat the immediate consequence of suicide
attempt
b. Early crisis intervention
c. Consider it as medico legal case
(possible foul-play)
Lewy Body Dementia (LBD)
• A disease associated with abnormal deposits
of a protein called alpha synuclein in the
brain.
• These deposits, called Lewy bodies, affect
chemicals in the brain whose changes, in
turn, can lead to problems with thinking,
movement, behavior, and mood.
Dementia
• It is a collective term used to describe
various symptoms of cognitive decline, such
as forgetfulness.
• It is a symptom of several underlying
diseases and brain disorders.
• It is not a single disease in itself, but a
general term to describe symptoms of
impairment in memory, communication, and
thinking.
Special Features:
• Milieu Therapy
• Group Therapy
• Support Groups
Milieu Therapy
• Uses a therapeutic community
• Patients join a group of around 30, for
between 9 and 48 months.
• During their stay, patients are encouraged to
take responsibility for themselves and the
others within the unit, based upon a
hierarchy of collective consequences
PURPOSES OF MILIEU THERAPY
• Correct the redefine perception of stressors.
• Correct the maladaptive behavior.
• Develop adaptive coping.
• Acquire interpersonal and stress-
management skill.
• Manipulate the environment so that all
aspects of client’s hospital experiences are
considered therapeutic.
• Client is expected to learn adaptive coping,
interaction and relationship skill that can be
generalized to other aspects of his or her
life.
• Achieving client autonomy.
Role of nurse in milieu therapy
• Milieu therapy can take place in a variety of
inpatient and outpatient settings.
• In the hospital, nurses are generally the only
members of the IDT team who spend time
with the clients on a 24-hour basis Assume
responsibility for management of the
therapeutic milieu. In all settings, the
nursing process is use for the delivery of
nursing care.
• Ongoing assessment, diagnosis, outcome
identification, planning, implementation,
and evaluation of the environment are
necessary for the successful management of
a therapeutic milieu.
• In the therapeutic milieu, nurses are
responsible for ensuring that clients'
physiological needs are met.
Group Therapy
• Is a form of psychotherapy that involves one
or more therapists working with several
people at the same time
• Designed to target specific problem, such as
depression, obesity panic disorder, social
anxiety, chronic pain or substance abuse.
• Others focus more generally on improving
social skills, helping people deal with a
range of issues such as anger, shyness,
loneliness and low self esteem
Support Group
 Formed by people who are experiencing the
same issues or problems
 It provides an opportunity for people to
share personal experiences and feelings,
coping strategies, or firsthand information
about diseases or treatments.
 Here, the members provide each other with
various types of help, usually
nonprofessional and nonmaterial, for a
particular shared, usually burdensome,
characteristic
Group Therapy versus Support Group
The main difference is that each group therapy
session is led by at least one qualified therapist.
While both support groups and group therapy offer
support, the goal of group therapy is to help
members change, while the goal of support groups
is to help members cope.
Alcoholics Anonymous
• Alcoholics Anonymous is an international
mutual aid fellowship with the stated
purpose of enabling its members to "stay
sober and help other alcoholics achieve
sobriety."
 AA is nonprofessional, self-supporting, and
apolitical. Its only membership requirement
is a desire to stop drinking.
 a support groups