SUICI

DE
BY: KRISTINE KEEN BUAN
 INTRODUCTION
Suicide is the act of taking one’s own life.

According to the 
American Foundation for Suicide Prevention,
suicide is the 10th leading cause of death in the
United States, taking the lives of approximately
47,000 Americans each year.
 INTRODUCTION
According to WHO close to 800 000 people die
due to suicide every year, which is one person
every 40 seconds.

According to 2015 data from the 

Global Burden of Disease Study, suicide rates in
the Philippines are up to 1.9 for females, 5.8 for
males, and 3.8 for both sexes for every 100,000 of
the general population.
INTRODUCTION
Suicide is a serious public
health problem, however,
suicides are preventable
with timely, evidenced-
based and often low-cost
intervention.
LET’S DEFINE SUICIDE:
Originally the word suicide , founded
on latin language “sui” (oneself) and
“caedes” (killing)
LET’S DEFINE SUICIDE:
Constitute all cases of death directly
or indirectly resulting from act of a
person who is aware of the
consequences of the behaviour.
 “SUICIDE IS A
PERMANENT
SOLUTION TO A
TEMPORARY
PROBLEM”.
IF THIS IS SO OBVIOUS, THEN
WHY IS SUICIDE SO
DISTRESSINGLY COMMON?
 PREVALENCE OF SUICIDE
Over 800 000 people die due to suicide every year.

Stigma surrounding suicide leads to underreporting

data

75% of global suicides occur in low- and – middle

– income countries.

Ingestion of pesticide, hanging and firearms are the

most methods of suicide globally.
FACTORS AFFECTING SUICIDE RATE
 1. SEX
Men are better at suicide than women. Four times as men
complete suicide, but women make more attempts.

Male suicide attempts are more lethal because men typically

use a gun or an equally fatal method.

Women most often attempt a drug overdose, so there’s a better

chance of help.
 2. AGE
Suicide rates increase with age. More than
half of all suicide victims are over 45 years old.

In fact, suicide is more common among 15-24

years old.
 3. Marital Status
Marital Status is also related to suicide rates.
Married individuals have lower rates than divorced.
Widow, or single persons
 4. Health Factors
Mental Health Conditions
Depression
Bipolar (Manic depressive) disorder
Schizophrenia
Borderline or Antisocial Personality Disorder
Anxiety Disorders
Substance Abuse Disorders
Serious and Chronic Condition and/or Pain
 5. Psychological Factors
Hopelessness
Is one of the greatest predictors
for suicidal behavior.
• Aggression and impulsivity.
Lack of reasons for living
• Feeling of worthless and
helpless
•An extremely negative self-
image
•Cognitive rigidity (dichotomous)
•Poor problem-solving capabilities
6. Environmental Factors
• Stressful life events such as
death, divorce, or job loss
• Prolonged stress
• Access to lethal means
including firearms and drugs
• Exposure to another person’s
suicide
• Isolation and lack of social
support
 7. Historical Factors
• Previous Suicide
Attempts
A history of a suicide
attempt is a major risk
factor for both repeated
nonfatal suicidal
behavior and suicide.

• Family History of
Suicide Attempts
FORMS OF SUICIDE
1. Depressive (planned)
2. Impulsive
3. Away of Attracting
Attention
 MODE
OF
SUICIDE
BLEEDING
WRIST CUTTING
DROWNING
 SUFFOCATION
One is more likely to commit
suicide through gas
inhalation than attempting to
prevent breathing at all
together. Inert gas such as
helium, nitrogen and argon
or toxic gases such as carbon
monoxide are commonly
used in suicides by
suffocation due to their
ability to quickly render a
person unconscious, and
may cause death within
minutes.
ELECTRODUCTION
JUMPING FROM HEIGHT
FIREARMS
POISON
DRUG OVERDOSE
SUICIDE
WARNING SIGNS
SUICIDE WARNING SIGNS
TALK
•Direct statements ( I will end
my life)
•I can’t go on, “Nothing
matters anymore”, I wish I
were dead”
•Being a burden to others
•Experiencing unbearable
pain
•Having no reason to live
SUICIDE WARNING SIGNS
BEHAVIOR
•Looking for a way to kill themselves
•Acting recklessly
•Isolating from family and friends
•Sleeping too much or too little
•Visiting or calling people to say goodbye
•Giving away his own possessions.
SUICIDE WARNING SIGNS
MOOD
• Depression
• Loss of Interest
• Irritability
• Humiliation
• Anxiety
• Fear
PREVENTION
 PREVENTION
UNIVERSAL PREVENTION STRATEGIES
INCLUDE:

• Generally improving the quality of people’s lives thereby

reducing stress
• Decreasing the availability of lethal means, such as
control of guns
• Selective strategies include in schools and institutions so
that depressed and suicidal individuals can be identified
and treated before they harm themselves
• Focusing on high- risks groups those already diagnosed
as depressed
• Assert religious and cultural believes that discourage it.
PSYCHIATRIC ASSESSMENT
Suicidal behaviors are frequently
symptoms of underlying mental health
problems. Therefore, a suicide risk
assessment cannot be undertaken in
isolation from an overall mental health
assessment.
INTERVIEW PROCESS
Unlike medical interview, where the
patient and parents may be interviewed
together, a psychiatric interview must
include some time alone with each party,
especially when assessing the patient’s
potential dangerousness, to obtain a
complete picture of the problem.
DIRECT QUESTION…???
Contrary to popular myth, children and
adolescents do not become suicidal when
asked about suicidal thoughts. It is
extremely important that the physician ask
about suicidal ideation, plans, ao attempts
openly and frankly:

A patient who answers NO to these

questions is probably not telling the full
story.
 CURRENT SUICIDAL THOUGHTS
• Are suicidal thoughts and feelings present?

•What are these thoughts? (determine the

content, eg. Guilt or delusions)

•When did these thought begin?

•How frequent are they?

•How are persistent are they?

 CURRENT SUICIDAL THOUGHTS
•What has happened since these thoughts
started?

•Can the person control them?

•What has stopped the person from acting on

their thoughts so far?
 LETHALITY/INTENT
•What is the person’s degree of suicidal
intent?

•Was their attempt carefully planned or

impulsive?

•Has the person finalized personal business,

eg. given away their possessions and said
their goodbyes?
PRESENCE OF SUICIDE PLAN
•How far has the suicide planning proceeded?

•Specific method, place, time?

•How long has the person had the plans?

•How realistic are the plans?

ACCESS TO MEANS AND KNOWLEDGE

•Has the person made a special effort to find

out information about methods of suicide or
do they have particular knowledge about
using lethal means?

•Is there any item or aspect of the in-patient

environment that may be used as a means to
self harm?
ACCESS TO MEANS AND KNOWLEDGE

•Type of occupation? For example ,police

officer (access to gun), health worker (access
to drugs).
 SAFETY OF OTHERS
•Have the person’s thoughts ever included
harming someone else as well as himself or
herself?

•Has the person harmed anyone else?

•What is the person’s rationale for harming

another person?

•Is there a risk of murder-suicide?

 COPING POTENTIAL OR CAPACITY
•Does the person possess the capacity to
enter into a therapeutic alliance?

•Personal strengths or effective coping

strategies: How have they managed previous
life events and stressors?

•Are there social or community supports (eg.

Family, friends, church, general practitioner)?
NURSING OBSERVATION
DURING
HOSPITALIZATION
NURSING OBSERVATION LEVELS
• On admission, the doctor, in consultation with
the senior nurse, is to determine the category of
nursing observation
• A clear explanation is to be given to the patient
about the reason for the observation level.
• Levels are to be reviewed throughout each
shift by the treating team and report to senior
nurse to minimize the level of unnecessary
restriction to the patient’s rights.
 HIGH LEVEL OF IMMEDIATE RISK
Patient is to be contained in a locked facility.
•Patient is to be nursed on a 1:1 basis
•Nurse is to be in close proximity to patient
•Patient is to be checked for signs of life (eg.
respiration) each 10 minute interval throughout
the night and these are to be documented.
•There is no leave to be granted
•Individual observation chart kept as part of
patient’s medical record.
 PATIENT IS ASSESSED AS LOWER
LEVEL OF RISK OF SUICIDE OR SELF-
HARM

•Patient is checked every 30 minutes

throughout the day and night
•Patient is confined to the ward
•Patient must be with a member of staff when
out of the unit
•Individual patient’s observation kept as part
of patient’s medical record.
PATIENT IS CURRENTLY NOT IN SELF-
HARM RISK

•Patient is checked every 2 hours and at

change of shift
NURSING INTERVENTION
 NURSING INTERVENTION
•The client’s room should be near the nurses’
station and within view of the staff , not near to an
elevator, stairs and exit.

•Be alert to the possibility of the client saving up

his or her medications or obtaining medications
or dangerous objects from other client or visitors.
You may need to check the client’s mouth after
medication administration or use liquid
medications to ensure that they are ingested.
 NURSING INTERVENTION
•Convey that you care about the client and that
you believe the client is a worthwhile human
being.
•Give the client support for efforts to remain out
of his/her room, to interact with other clients, or
to attend activities.
 NURSING INTERVENTION
•Encourage and support the client’s expression of
anger. (Remember: Do not take the anger
personally)
•Involve the client as much as possible in
planning in his/her treatment
•Examine the client his/her environment and
relationships outside the hospital.
 TYPES OF THERAPY
•Family Therapy
•Cognitive Behavioral Therapy (CBT)
•Problem-solving Therapy
•Group Therapy
•Medications
Shared by: Kristine Keen Buan
BSN III