Suicide and self-injurious behavior -
assessment and care
Wednesday, September 15, 2021 20:28
1. Beliefs r/t suicide
1. It’s a cowardly act, they don’t care that it hurts others
2. Only happens in people who aren’t like me or my
friends/family, etc
3. Cant be stopped — “they will find a way” no matter what
others might do
4. We can help suicidal people on our own, don’t need to
involve mental health professionals
5. People who talk about don’t do it
6. Talking about is can plant a seed” and lead to a suicide that
otherwise might not have happened
7. People who have made non-lethal attempts really don’t
want to die, or are at less risk of committing suicide later
8. People should be able to handle it on their it’s a failure of
character, d/t a lack of willpower or effort
9. It brings shame upon those left behind
10. It’s a sin
11. CONSIDER: where do you stand on these ideas? On what
are your beliefs about suicide based? Have your views
changed over time?
12. NOTE: advocates recommend “died by/from suicide”
rather than “committed suicide” (less stigmatizing, more
normalizing, akin to died from cancer”)
2. Why do people attempt suicide?
1. Hopelessness
2. Despair
3. Depression
4. A desire to end suffering
5. Feeling overwhelmed
6. Cannot see their life getting better
, 7. Unable to develop alternatives (not coping)
8. Believe they are a burden on others
9. Believe their death will benefit others
10. Guilt
11. Self-directed anger
12. Anger at others
13. A response to rejection
14. A response to loss (real or imagined, tangible or intangible)
1. Relationships
2. Face
3. Status
4. Diminished role or value (e.g. unemployment,
retirement, children leave parents to empty nest)
15. A response to illness and its consequences
16. A response to abuse and trauma
17. A response to bullying and hatred (esp for sexually
different persons)
18. Modeling — a response to suicide by others
19. Risk increased by meds such as certain antivirals,
antidepressants in adolescents and young adults
20. KEY FACTORS: DESPERATION AND DESPAIR
3. One theory of suicide
1. Suicidality occurs when the pt perceives himself as isolated
and a burden to others
2. Suicide attempts occur when the suicidal pt acquires the
ability (courage) to take action
3. In this model, suicide requires bravery, not cowardism
1.
, 4. Significance of the problem
1. 1,000,000 suicides/year worldwide (2% of all deaths)
2. 500,000 deaths by suicide in US between 2000-2015
3. Each year more than 44,000 Americans die by suicide
4. 1 suicide every 12 min, and 120 suicides per day, in the US
(one per minute worldwide)
5. 15,246 suicides in Ohio between 2008-2017 (rank 32/50),
1740 in 2017
6. The suicide rate for people 18 to 19 increased 56%
between 2008 and 2017 (the rate for people 22 to 23
doubled).
7. The overall rate in Ohio increased 24% in 2008-2017
8. 31 in Portage Co in 2018, the highest number in 20 yrs
9. 10th leading cause of death overall (homicide is 15th);
10. 2nd leading cause of death of those 10-34 yrs old
11. The rate of suicide is highest in middle age, esp among
white males; the second highest rate is among the elderly,
followed by adolescents and young adults.
12. However, the fastest increase (most growth) in rates of
suicide is among those 15-24 years.
13. The rate in those 45-64 yo has increased 30% in last 10
years
14. Rates are increasing most for rural white males and urban
black males
15. The annual age-adjusted suicide rate is 12.93 per
100,000.The US suicide rate has increased every year for
the last 15 years, increased >20% overall between
2000-2015, and are now at a 30 year high in 2018
16. Men die by suicide 3.5x more often than women; 3.7 male
deaths by suicide for each female suicide.
17. White males accounted for 7 of 10 suicides in 2014.
18. There are an estimated 959,100 annual attempts in U.S.
(using 25:1 ratio attempts to completed suicides)
19. For every suicide there are an estimated 25 attempts (one
attempt every 32 seconds)
20 An estimated 4 73 million Americans are survivors of
assessment and care
Wednesday, September 15, 2021 20:28
1. Beliefs r/t suicide
1. It’s a cowardly act, they don’t care that it hurts others
2. Only happens in people who aren’t like me or my
friends/family, etc
3. Cant be stopped — “they will find a way” no matter what
others might do
4. We can help suicidal people on our own, don’t need to
involve mental health professionals
5. People who talk about don’t do it
6. Talking about is can plant a seed” and lead to a suicide that
otherwise might not have happened
7. People who have made non-lethal attempts really don’t
want to die, or are at less risk of committing suicide later
8. People should be able to handle it on their it’s a failure of
character, d/t a lack of willpower or effort
9. It brings shame upon those left behind
10. It’s a sin
11. CONSIDER: where do you stand on these ideas? On what
are your beliefs about suicide based? Have your views
changed over time?
12. NOTE: advocates recommend “died by/from suicide”
rather than “committed suicide” (less stigmatizing, more
normalizing, akin to died from cancer”)
2. Why do people attempt suicide?
1. Hopelessness
2. Despair
3. Depression
4. A desire to end suffering
5. Feeling overwhelmed
6. Cannot see their life getting better
, 7. Unable to develop alternatives (not coping)
8. Believe they are a burden on others
9. Believe their death will benefit others
10. Guilt
11. Self-directed anger
12. Anger at others
13. A response to rejection
14. A response to loss (real or imagined, tangible or intangible)
1. Relationships
2. Face
3. Status
4. Diminished role or value (e.g. unemployment,
retirement, children leave parents to empty nest)
15. A response to illness and its consequences
16. A response to abuse and trauma
17. A response to bullying and hatred (esp for sexually
different persons)
18. Modeling — a response to suicide by others
19. Risk increased by meds such as certain antivirals,
antidepressants in adolescents and young adults
20. KEY FACTORS: DESPERATION AND DESPAIR
3. One theory of suicide
1. Suicidality occurs when the pt perceives himself as isolated
and a burden to others
2. Suicide attempts occur when the suicidal pt acquires the
ability (courage) to take action
3. In this model, suicide requires bravery, not cowardism
1.
, 4. Significance of the problem
1. 1,000,000 suicides/year worldwide (2% of all deaths)
2. 500,000 deaths by suicide in US between 2000-2015
3. Each year more than 44,000 Americans die by suicide
4. 1 suicide every 12 min, and 120 suicides per day, in the US
(one per minute worldwide)
5. 15,246 suicides in Ohio between 2008-2017 (rank 32/50),
1740 in 2017
6. The suicide rate for people 18 to 19 increased 56%
between 2008 and 2017 (the rate for people 22 to 23
doubled).
7. The overall rate in Ohio increased 24% in 2008-2017
8. 31 in Portage Co in 2018, the highest number in 20 yrs
9. 10th leading cause of death overall (homicide is 15th);
10. 2nd leading cause of death of those 10-34 yrs old
11. The rate of suicide is highest in middle age, esp among
white males; the second highest rate is among the elderly,
followed by adolescents and young adults.
12. However, the fastest increase (most growth) in rates of
suicide is among those 15-24 years.
13. The rate in those 45-64 yo has increased 30% in last 10
years
14. Rates are increasing most for rural white males and urban
black males
15. The annual age-adjusted suicide rate is 12.93 per
100,000.The US suicide rate has increased every year for
the last 15 years, increased >20% overall between
2000-2015, and are now at a 30 year high in 2018
16. Men die by suicide 3.5x more often than women; 3.7 male
deaths by suicide for each female suicide.
17. White males accounted for 7 of 10 suicides in 2014.
18. There are an estimated 959,100 annual attempts in U.S.
(using 25:1 ratio attempts to completed suicides)
19. For every suicide there are an estimated 25 attempts (one
attempt every 32 seconds)
20 An estimated 4 73 million Americans are survivors of
