Suicide Prevention Strategies PDF

11/16/23, 10:56 AM Realizeit for Student Outcome Identification Suicide prevention usually involves treating the underlying disorder, such as mood disorder or psychosis, with psychoactive agents. The overall goals are first to keep the client safe and later to help him or her develop new coping sk...

11/16/23, 10:56 AM Realizeit for Student Outcome Identification Suicide prevention usually involves treating the underlying disorder, such as mood disorder or psychosis, with psychoactive agents. The overall goals are first to keep the client safe and later to help him or her develop new coping skills that do not involve self-harm. Other outcomes may relate to activities of daily living, sleep and nourishment needs, and problems specific to the crisis, such as stabilization of psychiatric illness/symptoms. Examples of outcomes for a suicidal person include the following: The client will be safe from harming self or others. The client will engage in a therapeutic relationship. The client will establish a no-suicide contract. The client will create a list of positive attributes. The client will generate, test, and evaluate realistic plans to address underlying issues. Intervention Using an Authoritative Role Intervention for suicide or suicidal ideation becomes the first priority of nursing care. The nurse assumes an authoritative role to help clients stay safe. In this crisis situation, clients see few or no alternatives to resolve their problems. The nurse lets clients know their safety is the primary concern and takes precedence over other needs or wishes. For example, a client may want to be alone in his or her room to think privately. This is not allowed while he or she is at an increased risk for suicide. Providing a Safe Environment Inpatient hospital units have policies for general environmental safety. Some policies are more liberal than others, but all usually deny clients access to materials on cleaning carts, their own medications, sharp scissors, and penknives. For suicidal clients, staff members remove any item they can use to commit suicide, such as sharp objects, shoelaces, belts, lighters, matches, pencils, pens, and even clothing with drawstrings. Again, institutional policies for suicide precautions vary, but usually staff members observe clients every 10 minutes if lethality is low. For clients with high potential lethality, one-to-one supervision by a staff person is initiated. This means that clients are in direct sight of and no more than 2 to 3 ft away from a staff member for all activities, including going to the bathroom. Clients are under constant staff observation with no exceptions. This may be frustrating or upsetting to clients, so staff members usually need to explain the purpose of such supervision more than once. No-suicide or no-self-harm contracts have been used with suicidal clients. In such contracts, clients agree to keep themselves safe and to notify staff at the first impulse to harm themselves (at home, https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IUZWdjLO5UHpukqIHual8pZRZOPKGxj61nPC0Rzizzdwuu… 1/2 11/16/23, 10:56 AM Realizeit for Student clients agree to notify their caregivers; the contract must identify backup people in case caregivers are unavailable). These contracts, however, are not a guarantee of safety, and their use has been sharply criticized. At no time should a nurse assume that a client is safe based on a single statement by the client. Rather a complete assessment and a thorough discussion with the client are more reliable. Shifting the focus to “safety planning,” that is, managing or mitigating suicidal risk, is a more effective intervention strategy (Stallman, 2018). Creating a Support System List Suicidal clients often lack social support systems such as relatives and friends or religious, occupational, and community support groups. This lack may result from social withdrawal, behavior associated with a psychiatric or medical disorder, or movement of the person to a new area because of school, work, or change in family structure or financial status. The nurse assesses support systems and the type of help each person or group can give a client. Mental health clinics, hotlines, psychiatric emergency evaluation services, student health services, church groups, and self-help groups are part of the community support system. The nurse makes a list of specific names and agencies that clients can call for support; he or she obtains client consent to avoid breach of confidentiality. Many suicidal people do not have to be admitted to a hospital and can be treated successfully in the community with the help of these support people and agencies. Mental Health Promotion Because suicide is a leading cause of death among adolescents, prevention, early detection, and treatment are important. Strengthening protective factors (those factors associated with a reduction in suicide risk) would improve the mental health of adolescents. Protective factors include close parent–child relationships, academic achievement, family life stability, and connectedness with peers and others outside the family. School-based programs can be universal (general information for all students) or indicated (targeting young people at risk). Indicated or selective programs have been more successful than universal programs. Likewise, screening for early detection of risk factors such as family strife, parental alcoholism or mental illness, history of fighting, and access to weapons in the home can lead to referral and early intervention. In addition, bullying and cyberbullying require joint efforts of parents, families, and schools to decrease victimization of youth and prevent suicide among young people who are the targets of these activities (Zaborskis, Ilionsky, Tesler, & Heinz, 2018). https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IUZWdjLO5UHpukqIHual8pZRZOPKGxj61nPC0Rzizzdwuu… 2/2