Suicide Risk

Be Aware Of Patients At High Risk For Suicide

Patients at High Risk For Suicide

Males
Complete suicide by violent means, such as using Firearms, or Hanging themselves, intentional motor vehicle accidents 4 times more likely to die from suicide than females

Females
Attempt suicide more frequently than males Are less successful at completing suicide than males Completed suicides usually choose non-violent means such as: overdosing

Patients at High Risk For Suicide

Accidents may not be accidental.
Be alert for: Single vehicle motor vehicle accidents Burns Accidental gun shot wounds

Assess for suicide risk.

Patients at High Risk For Suicide

Age Factors
Suicide is the 3rd leading cause of death for males & females ages 15 24 Suicide & suicide attempts are highest for women ages 25 44 Suicide attempts more likely for those under age 25 and over 45 Suicide rates are highest among white males 65 and older (risk increases after age 80)

Summary: youth & elderly at highest risk

Alcohol & Drug Abuse

Depression and alcohol abuse is associated with completed suicides Alcohol is associated with nearly 50% of all suicides High risk of accidental overdose for drug abusers

If theyve been drinking, assess for suicide risk.

Separated, Divorced, Widowed, Single

These patients are at higher risk for suicide compared to people in stable, intimate relationships

Inquire if any recent relationship losses

No Social Support
Those who feel isolated and cut off from other people are at greater risk

Determine availability for support, and mobilize social support

Rational Thinking Loss

Appears to be in a fog, not with it Disoriented in time or space Loss of concentration Difficulty remembering or making decisions Bizarre or irrational thoughts (including hallucinations) Self-critical statements Unwarranted conclusions (they would be better off if I were dead) Overwhelming negative expectations

Assess for suicide risk.

Previous Attempt Or Psychiatric Care

The best predictor of completed suicide is a history of attempted suicide. The second suicide attempt has a much higher rate of completion The more violent the past suicide attempts, the greater the need for patient safety

Ask What is the most serious past suicide attempt?

Depression
Highest risk group for suicide is Depression with:
Alcohol use / abuse Cocaine use Separation or Divorce

Depression or mood disorder is the most common psychiatric disorder linked with suicide

Questions To Ask Regarding Depression

Movements: slow and deliberate? Seems sad? Sleep increased or decreased? Appetite increased or decreased? Isolating? Enjoy activities they have always enjoyed? No stated future intent

Ways To Ask
Are you thinking of harming yourself? Have you tried to harm / kill yourself before? Are you thinking about that again?

Common Myths About Suicide

If you ask someone if they are suicidal it will make them suicidal NO! This is NOT correct. Frequent attempts at suicide means they probably wont kill themselves. Theyre just doing it for the attention. NO! This is NOT correct. Patients with physical illness or injury dont need a suicide assessment. NO! These patients may be at risk if they are in the previous categories presented.