BH_E1_Suicide
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Questions and Answers

Which of the following factors is NOT typically associated with an increased risk of suicide?

  • High socioeconomic status (correct)
  • Diagnosis of Schizophrenia
  • Diagnosis of Major Depressive Disorder
  • History of Traumatic Brain Injury

What percentage of patients who attempt suicide have seen a healthcare provider within the month prior to their attempt?

  • 53%
  • 38%
  • 95%
  • 64% (correct)

A firearm in the home increases the likelihood of suicide attempt by how much?

  • 2x
  • 11x (correct)
  • 5x
  • 8x

What is the MOST accurate interpretation of 'socially sanctioned' when discussing Non-Suicidal Self-Injurious Thoughts?

<p>That the behavior is often misunderstood, yet quietly tolerated or normalized within certain subcultures. (A)</p> Signup and view all the answers

Among psychiatric diagnoses, which condition presents the HIGHEST risk of mortality by suicide?

<p>Eating Disorders (C)</p> Signup and view all the answers

Which of the following terms describes a behavior intended to lead others to believe one wants to die, despite lacking any actual intention to end their life?

<p>Suicide gesture (B)</p> Signup and view all the answers

A patient is brought to the clinic by their roommate, who reports overhearing the patient say, 'If my partner leaves me, I’ll kill myself'. According to the definitions, this statement is best categorized as which of the following?

<p>Suicide threat (A)</p> Signup and view all the answers

What percentage of individuals who commit suicide are seen by a healthcare provider within the month preceding their death?

<p>64% (B)</p> Signup and view all the answers

Which of the following conditions carries the highest risk of suicide?

<p>Eating disorder (D)</p> Signup and view all the answers

What is the most common means of suicide completion in the general population?

<p>Firearms (A)</p> Signup and view all the answers

Which demographic group has the highest rate of suicide completion?

<p>Adult Males (A)</p> Signup and view all the answers

A patient is being discharged from inpatient psychiatric care. How much higher is the patient's risk of suicide in the first week after discharge compared to the general population?

<p>300 times higher (B)</p> Signup and view all the answers

Which of the following is classified as a 'static' risk factor for suicide?

<p>Previous suicide attempt (B)</p> Signup and view all the answers

According to the IS PATH WARM mnemonic, what does the 'T' stand for?

<p>Trapped (B)</p> Signup and view all the answers

A clinician is concerned about a patient's suicide risk. Which of the following actions should the clinician perform?

<p>Inquire directly about suicidal intent, plan, and access to means. (C)</p> Signup and view all the answers

Which demographic is MOST likely to successfully complete suicide?

<p>Unmarried men (A)</p> Signup and view all the answers

What is the estimated likelihood of a patient dying within the first month after psychiatric hospitalization, compared to the general population?

<p>200x higher (A)</p> Signup and view all the answers

Which of the following factors is considered a static risk factor for suicide?

<p>Previous suicide attempt (C)</p> Signup and view all the answers

According to the 'IS PATH WARM' mnemonic, assessing which of the following is crucial in evaluating suicide risk?

<p>Hopelessness (A)</p> Signup and view all the answers

What concerning effect does livestreaming a suicide potentially NOT have?

<p>Reduced suicide contagion (A)</p> Signup and view all the answers

Among the following, which represents the MOST advanced stage of suicidal behavior?

<p>A previous suicide attempt (B)</p> Signup and view all the answers

Which action should a clinician undertake to assess suicide risk, and which is a common misconception about this action?

<p>Inquire directly about suicidal thoughts; this will NOT increase those thoughts. (A)</p> Signup and view all the answers

A 20-year-old transgender woman is admitted to the emergency department for suicidal ideation. Based solely on the provided data, how does her risk of attempting suicide compare to the general population?

<p>Twelve times more likely than the general population (C)</p> Signup and view all the answers

When a patient is evaluated under the Baker Act, what is NOT a potential outcome following the evaluation?

<p>Mandatory enrollment in a vocational training program. (C)</p> Signup and view all the answers

What is the MOST significant predictor of a future suicide attempt?

<p>Previous suicide attempts. (B)</p> Signup and view all the answers

What is the PRIMARY limitation of 'Promise of No Suicide' contracts (aka contract for safety)?

<p>They lack legal enforceability and evidence supporting a decrease in suicide rates. (D)</p> Signup and view all the answers

Approximately how many individuals are affected by each suicide?

<p>135 (C)</p> Signup and view all the answers

What is a key element of suicide/litigation prevention when documenting behavioral health visits for potentially suicidal patients?

<p>Inquiring about and documenting suicidal/homicidal ideation, depressive/psych sxs, med compliance/ADEs, counseling, psychosocial support, pain, and sleep at each visit. (D)</p> Signup and view all the answers

Which factor is considered a protective factor against suicide?

<p>A strong sense of responsibility to family. (B)</p> Signup and view all the answers

A 2017 study indicated that patient follow-up contact (letters) post-discharge resulted in approximately how much fewer suicides, and was deemed what?

<p>1/3 fewer suicides + cost effective (B)</p> Signup and view all the answers

Which of the following factors is LEAST likely to adversely affect emotional biomarkers such as executive function and cognitive control?

<p>Mindfulness practices. (C)</p> Signup and view all the answers

When evaluating a patient at risk for suicide, which of the following aspects of a patient's plan provides the MOST critical information regarding the immediate danger?

<p>The availability of the means. (A)</p> Signup and view all the answers

A patient presenting with depressive symptoms mentions feeling hopeless but denies any active suicidal ideation. Which of the following is the MOST appropriate next step in assessing suicide risk?

<p>Inquire about the frequency, intensity, and duration of their hopelessness and any passive suicidal thoughts. (D)</p> Signup and view all the answers

According to the content, which of the following is NOT a criteria for initiating a Baker Act?

<p>The person is deemed medically unstable. (B)</p> Signup and view all the answers

You're working with a teenager who seems withdrawn. To assess their suicide risk comprehensively, whose input should you seek besides the patient's?

<p>The patient's parents or guardians. (C)</p> Signup and view all the answers

Which of the following actions is LEAST appropriate during the 'STAY' phase of the SCATT initial suicide intervention plan?

<p>Engaging the patient in a therapeutic conversation to explore their feelings. (B)</p> Signup and view all the answers

A middle-aged male patient with a history of depression and recent job loss presents with increased anxiety and irritability. He admits to owning a firearm and consuming alcohol daily to cope. Which of the following factors poses the GREATEST immediate dynamic risk for a suicide attempt?

<p>His daily alcohol use and access to a firearm. (C)</p> Signup and view all the answers

A patient states, 'I sometimes wish I could just go to sleep and never wake up.' How should a healthcare provider MOST appropriately respond to understand the patient's intent?

<p>Acknowledge their feelings and explore the reasons why they feel that way, including asking about their expectation of carrying out the plan, if any. (B)</p> Signup and view all the answers

During a follow-up appointment, a patient who previously expressed suicidal ideation reports feeling significantly better after starting antidepressant medication. They deny current suicidal thoughts but admit to giving away some personal belongings 'to lighten the load.' Which action is MOST appropriate?

<p>Explore the reasons behind giving away belongings, assess for ongoing ambivalence, and re-evaluate suicide risk. (B)</p> Signup and view all the answers

What is the primary purpose of routinely using the ASQ (Ask Suicide Questions) screening tool with patients?

<p>To identify individuals who may be at risk of suicide, particularly those who might not readily disclose their struggles. (B)</p> Signup and view all the answers

Which of the following is the MOST immediate first step in the Suicide Intervention Plan (SCATT)?

<p>Ensuring the patient is not left alone to guarantee immediate safety. (C)</p> Signup and view all the answers

Under the Baker Act, which criterion MUST be met to initiate involuntary institutionalization?

<p>The individual has a diagnosed mental illness and presents a danger to self or others. (C)</p> Signup and view all the answers

A patient is admitted under the Baker Act due to suicidal ideation. According to protocol, within what timeframe must a medical examination be conducted?

<p>Within 12 hours of admission. (C)</p> Signup and view all the answers

What is the primary limitation of using 'No Suicide Contracts' with patients at risk?

<p>There is limited evidence to support their effectiveness in reducing suicide rates. (B)</p> Signup and view all the answers

Which of the following emotional responses is MOST commonly experienced by suicide loss survivors?

<p>Guilt and self-blame. (C)</p> Signup and view all the answers

For providers of suicidal patients, what is the intended purpose of a 'psychological autopsy' following a patient's suicide?

<p>To systematically review the circumstances of the suicide to identify potential learning points and improve future care. (C)</p> Signup and view all the answers

In the context of suicide litigation prevention, which of the following is emphasized as CRUCIAL to document in patient records?

<p>Details of suicidal or homicidal ideation and depressive symptoms. (A)</p> Signup and view all the answers

Which of the following factors is considered a PROTECTIVE factor against suicide?

<p>Presence of children in the home. (C)</p> Signup and view all the answers

Within a suicide safety plan, what is the purpose of identifying 'warning signs'?

<p>To recognize early indicators of increased suicide risk and prompt proactive coping strategies. (C)</p> Signup and view all the answers

According to research cited, what was the approximate reduction in suicide rates observed in a study involving follow-up letters to patients after discharge?

<p>Approximately 50% reduction. (A)</p> Signup and view all the answers

Which of the following biomarkers is generally considered to have a NEGATIVE association with suicide risk based on the provided text?

<p>Increased levels of stress. (A)</p> Signup and view all the answers

Which term BEST describes thoughts about killing oneself that may include a detailed plan?

<p>Suicidal Ideation. (C)</p> Signup and view all the answers

A patient verbally expresses, 'If you leave me, I’ll kill myself,' without a genuine intent to die. According to the terminology provided, this is BEST classified as:

<p>Suicide Threat. (D)</p> Signup and view all the answers

Considering both protective factors and suicide safety planning, which integrated approach demonstrates the MOST comprehensive strategy for suicide prevention?

<p>Treating underlying psychiatric illnesses, enhancing problem-solving skills, and creating a personalized safety plan that includes warning signs, coping strategies, and social supports. (B)</p> Signup and view all the answers

Which of the following best describes a 'suicide threat'?

<p>Thoughts of self-injurious behavior verbalized to make others believe one wants to die, without actual intent. (A)</p> Signup and view all the answers

What differentiates non-suicidal self-injury (NSSI) from a suicide attempt?

<p>The presence or absence of intent to die. (A)</p> Signup and view all the answers

Approximately what percentage of individuals who attempt suicide are estimated to have been seen by a healthcare provider in the week preceding their attempt?

<p>38% (D)</p> Signup and view all the answers

For patients with mental health or substance abuse diagnoses who attempt suicide, what percentage is estimated to have been seen by a healthcare provider within the year preceding their attempt?

<p>73% (A)</p> Signup and view all the answers

What is the estimated annual cost attributed to suicide attempts and deaths in the United States, considering medical expenses and lost work?

<p>$1 trillion (B)</p> Signup and view all the answers

Which of the following is the MOST precise definition of 'suicidal ideation'?

<p>Thoughts about killing oneself; may include a plan. (C)</p> Signup and view all the answers

How does keeping a gun in the home affect the likelihood of its use in a suicide attempt compared to its use for self-defense?

<p>11 times more likely to be used for suicide. (B)</p> Signup and view all the answers

Which scenario BEST exemplifies a 'suicide gesture' according to the definitions provided?

<p>An individual takes a handful of pills, knowing they are not lethal, to gain attention from family. (D)</p> Signup and view all the answers

Which of the following psychiatric diagnoses is associated with the HIGHEST risk of suicide?

<p>Eating Disorders (C)</p> Signup and view all the answers

Addressing the underlying condition is a critical component of suicide prevention. Which of the following conditions, if effectively treated, would NOT contribute to reducing suicide risk?

<p>Cancer (B)</p> Signup and view all the answers

Which of the following is an individual risk factor that increases suicide risk?

<p>History of depression and other mental illnesses (C)</p> Signup and view all the answers

A patient discloses experiencing job loss, financial problems, and a sense of hopelessness. According to the information, these factors primarily fall under which category of suicide risk?

<p>Individual Risk Factors (B)</p> Signup and view all the answers

Which scenario exemplifies a societal risk factor that could increase the likelihood of suicide?

<p>A celebrity suicide receiving sensationalized media coverage, which includes showing the location and bereaved relatives. (D)</p> Signup and view all the answers

Which of the following is NOT typically a characteristic associated with the phenomenon of livestreaming suicide?

<p>Reduced suicide contagion due to the virtual nature (D)</p> Signup and view all the answers

According to the information, unsafe media portrayals of suicide include all of the following EXCEPT:

<p>Emphasizing the preventability of suicide through help-seeking (A)</p> Signup and view all the answers

A patient reports taking lamotrigine for a mood disorder. According to the provided information, what is the MOST important next step for the healthcare provider?

<p>Assess the patient for any changes in mood or suicidal ideation, as anticonvulsants have been linked to suicidality. (A)</p> Signup and view all the answers

Following a Baker Act evaluation, within what timeframe should an individualized treatment plan be documented?

<p>Within 5 days of admission. (D)</p> Signup and view all the answers

A patient with a history of prior suicide attempts is being discharged from inpatient psychiatric care. Compared to the general population, approximately how much higher is this patient's risk of suicide during the first month post-discharge?

<p>200 times higher (C)</p> Signup and view all the answers

Which of the following is a potential negative consequence of involuntary confinement for a patient?

<p>Decreased likelihood of future disclosure of suicidal ideation. (B)</p> Signup and view all the answers

What is a critical component for patients being discharged after inpatient psychiatric care, to reduce suicide risk?

<p>Detailed discharge planning with follow-up support and a safety plan. (A)</p> Signup and view all the answers

Considering the limitations of involuntary confinement, what is an essential component of ethical and effective care, that mitigates feelings of punishment?

<p>Engaging the patient in collaborative care planning to foster a sense of partnership. (C)</p> Signup and view all the answers

A psychiatrist is determining the least restrictive environment for a patient experiencing severe suicidal ideation. What is an example of this?

<p>Voluntary treatment. (A)</p> Signup and view all the answers

Which intervention strategy is MOST likely to foster a strong therapeutic alliance and reduce patient reluctance to seek help in the future, following a Baker Act?

<p>Integrating patient preferences and perspectives into the safety plan and post-discharge support system. (D)</p> Signup and view all the answers

What is the strongest single predictive factor for a future suicide attempt?

<p>Previous suicide attempt (A)</p> Signup and view all the answers

According to the content, which aspect of current suicidal ideation should be assessed FIRST?

<p>Intent. (A)</p> Signup and view all the answers

A patient discloses having suicidal thoughts. Which of the following questions is MOST crucial to ask NEXT to determine the immediate level of risk?

<p>“Do you have a specific plan to end your life?” (C)</p> Signup and view all the answers

A patient reports having suicidal thoughts but denies a specific plan. Which of the following follow-up questions would be MOST appropriate?

<p>&quot;Do you have access to the means to carry out a plan if you were to develop one?&quot; (B)</p> Signup and view all the answers

During a suicide risk assessment, a patient admits to having a detailed plan and access to the means to carry it out. According to the SCATT Suicide Intervention Plan, which action should the provider take FIRST?

<p>Ensure the patient's immediate safety. (D)</p> Signup and view all the answers

A clinician is creating a suicide safety plan with a patient. Which element is the MOST important to include?

<p>Recognition of warning signs for a suicidal crisis. (B)</p> Signup and view all the answers

What should a distraction kit contain to assist someone experiencing suicidal ideation?

<p>Items that engage the five senses and promote relaxation. (A)</p> Signup and view all the answers

A patient informs you that music concerts are a good distraction from their active suicidal ideations, but they currently cannot afford tickets to one. Which of the following is the MOST appropriate recommendation?

<p>Suggest exploring free community events or virtual concerts. (A)</p> Signup and view all the answers

What is the PRIMARY function of implementing tools, such as the ASQ Toolkit and the SAMHSA Suicide Safe App, within a clinical setting?

<p>To provide standardized methods for screening and initial risk assessment of suicide. (D)</p> Signup and view all the answers

Which of the following factors, if present in a patient's history, would LEAST directly contribute to an elevated suicide risk assessment?

<p>History of migraines (B)</p> Signup and view all the answers

What is the PRIMARY documented limitation of utilizing a 'Promise of No Suicide' contract with patients at risk?

<p>There is a lack of standardized training for their implementation. (C)</p> Signup and view all the answers

During the 'STAY' phase of the SCATT initial suicide intervention plan, what action should a healthcare provider prioritize?

<p>Ensuring the patient is not left alone and remains under direct observation. (C)</p> Signup and view all the answers

Within the SCATT suicide intervention plan, after ensuring the patient's immediate safety, what is the subsequent recommended step?

<p>Consulting with a supervisor or experienced colleague. (C)</p> Signup and view all the answers

In a designated Suicide Prevention Room, which of the following is the MOST critical consideration when assessing the environment?

<p>Removing any items that could potentially be used for self-harm. (A)</p> Signup and view all the answers

According to the information provided, who among the following professionals is legally authorized to initiate a Baker Act in the state of Florida?

<p>A psychiatric nurse (D)</p> Signup and view all the answers

According to the Baker Act, what is the MAXIMUM duration an individual can be held in a receiving facility for evaluation, assuming they are medically stable?

<p>72 hours (C)</p> Signup and view all the answers

Following a Baker Act evaluation, which of the following is NOT a possible outcome?

<p>Mandatory outpatient therapy (B)</p> Signup and view all the answers

Approximately how many individuals are estimated to be affected by each suicide death?

<p>135 (C)</p> Signup and view all the answers

Which of the following emotional responses is LEAST likely to be experienced by a suicide loss survivor?

<p>A sense of detachment and indifference (D)</p> Signup and view all the answers

For providers who have lost a patient to suicide, what is the primary purpose of conducting a 'psychological autopsy'?

<p>To understand the circumstances surrounding the suicide and identify potential areas for learning and improvement in practice (A)</p> Signup and view all the answers

According to the provided material, which of the following documentation practices is MOST critical for suicide litigation prevention in behavioral health visits?

<p>Detailed and consistent documentation of suicide/homicidal ideation, depressive symptoms, medication compliance, counseling, psychosocial supports, pain, and sleep at each visit (C)</p> Signup and view all the answers

In post-suicide attempt intervention, which of the following questions is designed to explore potential positive aspects, if any, of the patient's experience?

<p>&quot;What was positive about the experience?&quot; (C)</p> Signup and view all the answers

Which of the following is LEAST likely to be a component of a suicide relapse prevention protocol, based on the information provided?

<p>Focusing exclusively on past suicidal behaviors to understand patterns (C)</p> Signup and view all the answers

The 'Lock2Live' program primarily focuses on which aspect of suicide prevention?

<p>Reducing access to lethal means, particularly firearms (B)</p> Signup and view all the answers

A study from 1969-1974, involving follow-up letters to patients post-hospitalization for suicidal ideation or depression, demonstrated which of the following outcomes?

<p>Approximately a 50% reduction in suicides during the study period and lower rates even 13 years later. (D)</p> Signup and view all the answers

Which statement MOST accurately reflects the guidance provided to healthcare providers regarding interactions with families after a patient's suicide?

<p>Providers should empathize with the family's grief but avoid assuming blame, recognizing that families may project their feelings onto them. (D)</p> Signup and view all the answers

Considering the information on suicide prevention strategies, which approach represents the MOST immediate and direct access to assistance for an individual experiencing a suicidal crisis?

<p>Contacting the National Suicide and Crisis Lifeline by calling or texting 988. (C)</p> Signup and view all the answers

Flashcards

Non-Suicidal Self-Injurious Thoughts

Thoughts of engaging in self-harm without the intent to die.

988 Suicide Crisis Line

A system to call for immediate help with suicidal thoughts or actions.

Eating Disorders

A mental health condition with the highest risk of death by suicide.

Healthcare Visits Before Suicide Attempts

Seeing a healthcare provider shortly before a suicide attempt is more common than you think.

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Firearms and Suicide Risk

Storing a gun in the home increases the likelihood of suicide dramatically.

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Suicidal Ideation

Thoughts about killing oneself, possibly including a detailed method.

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Suicidal Attempt

A behavior with the intention of ending one's life, but which does not result in death.

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Suicide (Completed)

Behavior intended to end one's life that results in death.

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Suicide Threat

Verbal expression of wanting to engage in self-harming behavior to manipulate others, without the genuine intention of dying.

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Suicide Gesture

A behavior meant to make others believe the person wants to die, though they lack the true intent.

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Nonsuicidal Self-Injury

Deliberate destruction of body tissue without suicidal intent, often for reasons such as self-punishment or anxiety relief.

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Timing of Suicide & Healthcare

Many individuals who complete suicide have seen a healthcare provider shortly beforehand.

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Eating Disorders & Suicide

A condition that carries a particularly elevated risk of suicidal ideation and attempts.

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Static Suicide Risks

Suicide risk factors that cannot be altered.

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Suicide Completion by Gender

Higher suicide completion rates occur in males, though females attempt more often.

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High-Risk Groups

Veterans, those living alone, and LGBTQIA+ individuals are at higher risk.

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Suicide Risk Post-Psych Hospitalization

The risk is significantly elevated immediately following discharge from psychiatric hospitalization, remaining high for up to 4 years.

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Dynamic Suicide Risk Factors

Current suicidal ideations, substance abuse, and relationship quality.

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Static Suicide Risk Factors

Previous suicide attempt, family history of suicide, and adverse childhood experiences (ACEs).

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IS PATH WARM

Ideation, Substance abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood changes.

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Warning Signs: I’m a PA

Current Ideation, Intent, Plan, and Access to Means.

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Suicide Inquiry Impact

Assessing suicide risk will not increase suicidal thoughts.

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Baker Act

Legal procedure for temporary detention for mental health evaluation, typically requiring examination within 12 hours.

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Baker Act Outcomes

Release, Inpatient commitment, Outpatient commitment, Voluntary treatment.

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Suicide Attempt Predictor

A previous attempt is the single greatest predictor of a future suicide attempt.

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No-Suicide Contract

An agreement where a person promises not to commit suicide. Not legally binding and doesn't decrease suicide rate.

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Suicide Loss Survivor Impact

Guilt, PTSD, shame, anger, and isolation which impact over a hundred people per suicide.

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Protective Factors Against Suicide

Treat underlying illnesses, develop problem-solving skills and promote spirituality.

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Suicide Safety Plan Components

Safe environment, warning sign recognition, reasons for living, distractions, support networks, and professional help.

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Patient Follow-Up Impact

Regular contact can significantly reduce suicide rates and is cost-effective.

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Suicide Plan

Details including timing, location, lethality, availability of means, and preparatory actions.

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Suicidal Behaviors

Past attempts, aborted attempts, rehearsals, self-harm, and non-suicidal actions.

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Suicidal Intent

Extent to which a patient expects to carry out the plan and believes it to be lethal.

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Suicide Ambivalence

Explore reasons to die versus reasons to live to understand conflicting motivations.

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Suicide Warning Signs

Talking, writing, or thinking about suicide; giving away possessions; mood shifts; saying goodbyes.

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ASQ Screening Tool

Tool used to screen patients for suicide risk by asking specific questions.

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Suicide Intervention Plan (SCATT)

A plan to ensure the safety of a patient at risk for suicide including staying with them, consulting, appraising, terminating access and transporting.

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Suicide Loss Survivors

Individuals who have lost someone to suicide, often experiencing guilt, questioning, and emotional distress.

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Providers of Suicidal Patients

Feelings of guilt, fear of lawsuits, and trauma that may be experienced by providers of suicidal patients.

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Suicide & Litigation Prevention

Meticulously asking about and documenting suicidal/homicidal ideation, mental health symptoms, compliance with medication, and psychosocial stressors.

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Developing Suicide Safety Plan

Creating a safe environment, identifying warning signs, reasons for living, distractions, and connecting with support.

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Biomarkers

Stress, Diet, Sleep, Anxiety, Alcohol, Drugs, Smoking, Depression and Mindfulness.

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Suicide Cost (Economic)

The annual economic burden in the US due to attempted or completed suicides, encompassing medical costs and lost productivity.

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Died by Suicide

Behavior with the intent to end one's life that results in death.

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Underlying Conditions & Suicide

Always address the root cause when preventing suicide.

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Psychiatric Diagnoses & Suicide

Conditions like depression, bipolar, and anxiety elevate suicide risk.

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Individual Suicide Risk Factors

Previous attempts, mental illness, and job loss all elevate risk.

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Relationship Risk Factors

Bullying, loss, or violent relationships increase suicide risk.

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Community Suicide Risk Factors

Healthcare access and community violence are key factors.

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Societal Suicide Risk Factors

Stigma and media portrayals impact suicide rates.

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Livestreaming Suicide Phenomenon

Online content can normalize or encourage suicide.

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Medications & Suicide

Antidepressants & anticonvulsants linked, ask about them!

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Current Ideation Assessment

Assessing current suicidal thoughts.

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Access to Means

Availability of tools needed to complete suicide.

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Suicide Safety Plan

A structured approach to help patients manage suicidal thoughts.

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Warning Sign Recognition

Understanding triggers that could lead to a suicidal crisis.

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Internal Coping Strategies

Using personal techniques to cope with difficult feelings.

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Suicide "Distraction Kit"

A collection of enjoyable items for distraction and comfort.

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Voluntary Treatment

Treatment where a patient, deemed competent, willingly agrees to participate.

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Involuntary Outpatient Placement

Treatment mandated by legal order, where the patient may not agree.

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Individualized Treatment Plan

A written plan developed with the patient's input, detailing their treatment goals and strategies.

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Disadvantages of Involuntary Confinement

The negative impact of feeling punished, losing autonomy, and distrusting the care process.

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Forced Safety Precautions Impact

Patient agency decreases and the perception that care is collaborative between doctor and patient is removed.

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Safety Precautions Impact

Mental health resources can become overwhelmed within the health system.

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Suicide Risk After Psychiatric Hospitalization

A significantly elevated period for up to 4 years following release.

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Discharge Planning

Linked with follow-up support and safety, is essential

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Suicide Risk Factors

Increased risk factors for suicide include current alcohol use/abuse, family suicide, firearms at home, LGBTQAI+ identity, and prior attempts.

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Promise of No Suicide

An agreement between a healthcare provider and patient where the person promises not to commit suicide. It lacks proven effectiveness and isn't legally binding.

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SCATT Intervention Plan

SCATT: Stay, Consult, Appraise, Terminate, Transport. A structured method to ensure the safety of a patient at risk of suicide.

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Suicide Prevention Room

A room prepared to minimize suicide risk by removing potentially harmful items within a facility.

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Baker Act Criteria

Evidence of possible mental illness and/or danger to self/others/self-neglect.

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Baker Act Time Limit

A person can be held up to 72 hours in a designated facility for evaluation. Exams are required within 12 hours.

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The "Why" Question

Recurring questioning and rumination experienced by suicide loss survivors.

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Survivor's Guilt

A common emotion felt by those left behind after a suicide.

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PTSD in Survivors

A potential mental health consequence for those affected by a suicide.

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Importance of Emoting

Encouraging open expression of feelings to aid healing.

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Delay Major Decisions

Delayed action on important aspects of life.

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Provider's Grief

What providers experience after a patient's death.

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Psychological Autopsy

A review to understand the circumstances of a suicide.

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Behavioral Health Documentation

Detailed inquiries about a patient's mental state during behavioral health visits.

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Post-Attempt Coping Strategies

Strategies to help patients develop new coping mechanisms after a suicide attempt.

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Suicide Threat (Manipulation)

Verbalizing thoughts of self-harm intended to make others believe one wants to die, even without the actual intent.

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Nonsuicidal Self-Injury (NSSI)

Destruction of body tissue without the intent to die, often a coping mechanism.

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Recent Healthcare Visit & Suicide

Approximately 66% of individuals who commit suicide had been seen by a healthcare provider in the month before their death

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Transgender & Attempted Suicide

Transgender individuals are statistically more likely to attempt suicide

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Post-Discharge Suicide Risk

The first week after discharge from a psychiatric hospital is the period of highest risk

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Sudden Calm Before Suicide

Actions include sudden calmness and final arrangements, assess immediately for intent, plan, and access

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Depression/Breakup Assessment

Inquire directly about suicidal ideation, intent, plan, and access to means

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SCATT First Step

Ensure the patient is not left alone to prevent immediate harm

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Grief support strategy

Suggest the patient participate in death rituals and delay major decisions if possible.

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Suicide Safety Plan Focus

Focuses on removing access to lethal means, not ensuring access to them.

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Clinician Self-Care

Focus on self-care practices and seek support through counseling or peer groups.

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Non-suicidal self-injurious behavior

self-harm without the primary intent to die.

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Evaluating Suicide Risk

Initiating an immediate psychiatric evaluation for suicidal ideation and safety assessment

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A suicide management plan

Conducting a thorough suicide risk assessment and developing a safety plan

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Firearm Risks

The presence of a firearm in the home increases the risk of suicide.

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Suicides economic impact

Suicide has a substantial economic impact, costing billions of dollars annually due to lost productivity, healthcare expenses, and other related costs.

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Non-suicidal thoughts definition

thoughts involve contemplating self-harm without the goal of causing death.

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What BPD patients need

Developing a comprehensive safety plan that includes trigger identification, coping strategies, and access to support systems

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Childhood Suicide

Suicide is among the top 10 leading causes of death for this age group. Any mention of suicidal ideation in a child should be taken seriously and assessed.

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Mental health assessment

Initiating a direct and thorough inquiry about suicidal ideation, including frequency, intensity, and plans

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Ambivalence

Complete the Ask Suicide Questions (ASQ) Screening Tool and further explore the ambivalence of their feelings.

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Interview with youth

Interview the patient alone to directly inquire about suicidal ideation, plans, and any self-harm behaviors.

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Substance use abuse/ Suicide risks

The patient's history of alcohol abuse and impulsivity

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What a provider does when caring for a medically unstable patient

Under the Baker Act (and similar involuntary commitment laws), a person can typically be held for up to 72 hours for evaluation, provided they are medically stable and meet the criteria for potential harm to self or others due to mental illness.

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Gender suicide

Men are more likely to die by suicide than women, though they attempt suicide less often. This is often attributed to the methods used

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Discharge from psychiatric hospitalization

The risk of suicide is highest in the first week after discharge from psychiatric hospitalization, approximately 300 times higher than the general population.

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Remember your PTSD now!

Trapped, representing the feeling of being stuck or unable to escape a situation

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Online dangers

Validation and encouragement of suicide, along with suicide contagion

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Danger to self or others

Method that the patient may use, such as firearms or poisoning.

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Suicide

An act of ending one's own life.

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Suicidal Thoughts

Thoughts of engaging in self-harm with the intention of ending one's life.

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Protective Factors

Factors that decrease the likelihood of suicidal behavior.

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Study Notes

Suicide Rates

  • Suicide rates decreased in 2018 and 2019.
  • The rate among males in 2021 was approximately four times higher than among females.
  • Males make up 50% of the population but nearly 80% of suicides.
  • In 2022, white males accounted for 68.46% of suicide deaths.
  • Suicide rates tend to be highest particularly in the Spring.
  • Racial/ethnic groups with the highest rates in 2022 were non-Hispanic American Indian and Alaska Native people, and non-Hispanic White people.
  • 46% of people who die by suicide have a diagnosed mental health condition.
  • 90% experienced symptoms of a mental health condition
  • A suicide attempt costs $1 trillion/year to medical expenses and lost work in the US

Common Suicide Methods

  • Firearms are most common and used in more than 50% of suicides
  • A gun at home is 11X more likely to be used to commit/attempt suicide.
  • Other methods include motor vehicle "accidents," gas, drowning, suicide by cop (100/year)
  • Suicide rates involving Falls can be monitored to determine saves versus suicides involving locations like Skyline Bridge

Suicide Safety

  • It is essential to remove anything that the patient could potentially use to harm themselves.

Suicide Risk: Assessment

  • No assessment is 100% accurate
  • A PA, or plan and intent may be warning signs
  • Women tend to use poisoning as the means to commit suicide.

Columbia Suicide Screen

  • It is a fast screen with thorough assessment if positive
  • It is the most widely researched

Suicide Distraction and Safety Planning

  • In internal copying skills, journaling and gratitutde can play a key role.
  • Positive self talk, prayers and meditation are key for suicide patients in danger of suicide

Medications

  • Medications that can contribute to thinking about suicide are antidepressants, smoking cessation drugs and anabolic steroids.

Screening for suicide

  • Everyone over 11 years of age should be screened
  • Children between the ages of 8-11 should be screened based on the clinical recommendations.
  • LGBTQAI+ are a high risk population and should be screened

Treatment

  • The suicide treatment plan must include a space for the patient's comments.

SCATT: Initial Suicide Intervention Plan

  • Consists of staying with the patient and limiting access to means.

No Suicide "Contract" or "Contract for Safety"

  • Few studies support use, this is not a legally binding or protective document

Suicide Loss Survivors

  • This includes asking "why, what if," feeling guilt and responsibility, or visiting/not visiting death scene.

Preventing Suicide

  • If you feel you have done everything that you can but patient still attempts, talk it over to your team, it is not your fault, you took safety precautions.

Suicide Assessment and Risk Evaluation

  • It is understood that no assessment is 100% accurate.

Baker Act

Must show medical illness or self neglect

Side Effects

Involuntary Confinement is perceived as a punitive

Risk of Suicide

The risk of suicide is 300x in first week after psychiatric visit. Be sure to plan discharge and follow up appropriately.

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Description

This lesson covers key risk factors associated with suicide, including mental health conditions, access to lethal means, and recent healthcare visits. It also addresses terminology related to suicidal ideation and behavior, such as socially sanctioned self-harm and threats of suicide.

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