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Suicide: KF Khan Clinical Psychologist

Content taken from Oxford Textbook of Psychiatry. Suicide. Causes. Methods. Iconic Sites. Epidemiology. Risk factors. Protective Factors. Religion Statistics. Assessment. Prevention. Management Plan

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KF Khan
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68 views23 pages

Suicide: KF Khan Clinical Psychologist

Content taken from Oxford Textbook of Psychiatry. Suicide. Causes. Methods. Iconic Sites. Epidemiology. Risk factors. Protective Factors. Religion Statistics. Assessment. Prevention. Management Plan

Uploaded by

KF Khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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SUICIDE

Presented By
KF Khan
Clinical Psychologist

SUICIDE
The word suicide comes from two
Latin roots,sui (of oneself)
andcidium (killing or slaying).
Suicide is a deliberately initiated act
with the knowledge of its fatal
outcome.

METHODS OF SUICIDE
People may take their lives in one of the following ways:
Hanging
Self-poison
Drug Overdose
Drowning
Jumping
Gunshot
Other violent methods

MOST COMPLETED SUICIDES HAVE BEEN


PLANNED.

ICONIC SITES FOR SUICIDE


Particular sites acquire iconic status as places for suicide.
Such places are usually public, attractive, have aesthetically pleasing
structure.
The nature and persistence of media reporting of suicides from such
sites makes local history, tradition and myth. All these features likely
combine to render a place as an iconic site for suicide.
People tend to make their choice of method of suicide based upon their
perceptions of what they understand to be certain to achieve death,
to be quick,
to be readily available,
and to avoid risk of disfigurement.
For example,
By jumping off bridges (Golden Gate Bridge)
or minarets (Minar.e.Pakistan).

EPIDEMIOLOGY OF
SUICIDE
Suicide is the 10th leading cause of
death in US.
Suicide is 3 times more common in
men than in women.
Suicide rate is higher in elderly.
Suicide is lower in married people as
compared to the ones never married.
Highest in health care professionals.

CAUSES OF SUICIDE
MEDICAL FACTORS

Depressive Disorders.36-90%
Alcohol Dependence..43-54%
Drug Dependence.04-45%
Schizophrenic..0310%
Personality Disorders.....05-44%
Past History of DSH
Poor Physical health
Chronic pain

CAUSES OF SUICIDE
SOCIAL FACTORS
High unemployment
Poverty
Social fragmentation
Media Coverage of suicide

CAUSES OF SUICIDE
BIOLOGICAL FACTORS
Family history
Decreased activity of serotonin

PSYCHOLOGICAL FACTORS

Hopelessness
Impulsivity
Aggression
Dichotomous Thinking
Cognitive Constriction
Problem Solving Deficits

Problems that can potentially trigger


suicidal thoughts in a young person
Death of a parent.
Divorce of parents.
Joining a new family with a step-parent and stepsiblings.
Breaking up with a boyfriend / girlfriend.
Moving to a new community.
Not feeling accepted by peers.
Being ridiculed by classmates.
Feeling misunderstood.
Any experience perceived to be "humiliating.
Alcohol abuse.
Drug abuse.

Durkheims 4 TYPES OF
SUICIDE
ANOMIC
Feel morally lost and have no
sense of direction in their
lives.
Example: Sexually abused
teenagers.

EGOISTIC
Low social integrity. Doesnt
have anyone to talk to.

ALTRUISTIC
Die for a higher cause
Example: suicide
bombers. Kamikaze.

FATALISTIC
Get tired of extreme
rules & expectations.
Feel oppressed of
society.
Example: Prisoners

RATIONAL SUICIDE & SUICIDE


PACTS
RATIONAL SUICIDE
The act of suicide based on reasoned
decision by mentally healthy people.
Example,
Usually happens due to a charismatic leader
who has strong convictions and is deluded.

SUICIDE PACTS
Two or more people agree that at the same
time each will take his or her own life.
Example,
Usually lovers aged less than 30 years

SUICIDE AMONG THOSE TAKING


PSYCHIATRIC TREATMENT
Support patients intensively during the first few
weeks after discharge from hospital.
Plan in advance the steps that should be taken if the
patient ceases to comply with the treatment.
Monitor side-effects of drugs
Ward Designs must be safe
Risk of suicide increases in depressive disorder
patients following initial treatment as psychomotor
retardation decreases.

SUICIDE IN DOCTORS
It has been found that doctors commit more suicide
than any other profession. This is because:
They are more exposed to peoples problems.
Know the exact dose of medication for committing
suicide
Greater access to lethal drugs
Such professionals are expected to be physically and
mentally healthy and hence they are reluctant to
seek treatment for suicidal ideation.
Do not get quality treatment as it is assumed that
such professionals know how to care for themselves.
Greater risk of burnout.

SUICIDAL RISK
There are two requirements for
doctors to assess suicidal risk:
1. Willingness to make direct but
tactful inquiries about a
patients intentions.

2. Be alert to factors that


predict suicide.

RISK FACTORS
Direct statement of intent
About two-thirds of those who die by suicide have
told someone of their intention.
Just before the act their maybe a subtle change in
their way of talking about dying.
Marked hopelessness
40-60% patients with previous suicidal attempts
Social isolation
Older age
Chronic painful diseases
Depressive disorder
Borderline Personality disorder
Schizophrenia

ASSESSING SUICIDE using


SAD PERSONS SCALE

Sex
Age
Depression
Past history of illness/Previous attempt
Ethanol or other substance abuse
Rational thinking loss (Psychosis, Cognitive Errors)
Separated/Single/Divorce/Widow
Organized Plan (high risk)
No social support
Stated intent (any future suicide plans)

Protective Factors from


Suicide
Researches have proven, religion
and marriage to be two strong
protective factors from suicide.

RELIGION AND SUICIDE

MANAGEMENT OF
SUICIDAL PATIENTS
Decide whether to admit patient In Ward or treat
as Outdoor patient.
Safe ward environment
Adequate number of well-trained nursing staff
Good working relationship between the staff
and between staff and patient
Assess risk
Agree the level of observation required
Remove objects that can be used for suicide
Discuss and agree on treatment plan with the
patient

Agree a policy of visitors


Clear communication between staff about
observations especially when the shift changes
Agree action to be taken if the patient leaves
the ward without permission
Agree date and plan for aftercare (follow-up)
Discuss the follow up and continued treatment
plan with those wholl care for the patient
Medicine prescribed should be in adequate but
non-dangerous amounts
Arrange follow-ups and agree action to be
taken if the patient doesnt attend

SUICIDE PREVENTIO
Better and more available psychiatric
services
Restricting the means of suicide
(detoxifying gas, car exhaust fumes, drug
overdose, points at prison or wards from
where hanging might be possible)
Encouraging responsible media
reporting
Educational programs
(campaigns about mental illnesses)
Improved care for high risk groups

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