Suicide

World Health Organization laid out six steps for worldwide suicide prevention: comprehensive and follow-up treatment of psychiatric patients, gun-possession control, detoxification of domestic gas and car emissions, and tempering the sensationalism of press reports of suicide.

instrumental acts of homicide that occur for some financial or other concrete gain.

a suicidal/homicidal person is one who is engaged in an expressive act designed to reduce psychological pain. Such suicidal/homicidal people are likely to be emotionally distraught, may feel gravely wronged, depressed, helpless, disempowered, and hopeless, and may attempt to solve their own di lemmas through harm to others and then to themselves

assisted suicide & euthanasia

A.S:someone else provides the means (lethal agent), but the person who is dying administers it

euthanasia someone else administers it

10 common characteristics

  1. Situational
  1. Motivational
  1. Affective
  1. Cognitive
  1. Relational
  1. Serial

consistency in suicide is with lifelong coping patterns when deep perturbation, distress, threat, and psychological pain are present

consistency in suicide is with lifelong coping patterns when deep perturbation, distress, threat, and psychological pain are present

action in suicide is egression: the right to exit or go out as one wishes, or the right to autonomously find a way out of one’s pain

cognitive state in suicide is ambivalence between doing it and wanting to be rescued

perception is of constriction such that one’s options become very narrowed and the world is seen through tunnel vision so that no alternative thoughts can emerge

emotions in suicide are hopelessness and helplessness

purpose of suicide is to seek solution

stimulus in suicide is unendurable psychological pain: The common stressor in suicide is frus- trated psychological need's

Assessment instruments

The Interpersonal Needs Questionnaire assesses the critical interpersonal issues of burdensomeness to others and lack of belongingness

Painful and Provocative Events Scale is a self-report of how much the client engages in impulsive, dangerous, pathological, and risk-taking activities

Acquired Capability for Sui- cide Scale, which indicates how lethal the client is

SAD PERSONS and BASIC are designed to assess manifestations of clinical suicide ide- ation and empirical factors that have been previously identified as being related to risk for suicide attempts.

  1. Exhibits the presence of suicidal or homicidal im- pulses and serious intent.
  1. Has a family history of suicide, threats of harm, and abuse of others
  1. Has a history of previous attempts
  1. Has formulated a specific plan
  1. Has experienced recent loss of a loved one through
    death, divorce, or separation
  1. Is part of a family that os destabilized as a result of loss, personal abuse, violence or/and because the client has been sexually abused
  1. Is preoccupied with the anniversary of a particularly traumatic loss
  1. Is psychotic (and may have discontinued taking
    prescribed medications)
  1. Has a history of drug and/or alcohol abuse
  1. Has had recent physical and/or psychological trauma
  1. Has a history of unsuccessful medical treatment, chronic pain, or terminal illness
  1. Is living alone and is cut off from contact with others
  1. Is depressed, is recovering from depression, or has recently been hospitalized for depression.
  1. Is giving away prized possessions or putting per- sonal affairs in order.
  1. Displaysradicalshiftsincharacteristicbehaviorsor moods, such as apathy, withdrawal, isolation, irri- tability, panic, or anxiety, or changed social, sleep- ing, eating, study, dress, grooming, or work habits
  1. Is experiencing a pervasive feeling of hopelessness/ helplessness.
  1. Is preoccupied and troubled by earlier episodes of experienced physical, emotional, or sexual abuse.
  1. Exhibits a profound degree of one or more emotions—such as anger, aggression, loneliness, guilt, hostility, grief, or disappointment—that are uncharacteristic of the individual’s normal emotional behavior.
  1. Faces threatened financial loss.
  1. Exhibits ideas of persecution.
  1. Has difficulty in dealing with sexual orientation.
  1. Has an unplanned pregnancy
  1. Has a history of running away or of incarceration
  1. Manifests ideas and themes of depression, death, and suicide in conversation, written essays, reading selections, artwork, or drawings.
  1. Makes statements or suggestions that he or she would not be missed if gone.
  1. Experiences chronic or acute stressors.

The Collaborative Assessment and Management of Suicidality (CAMS) is a risk assessment clinical interview framework

Chronological Assessment of Suicide Events (CASE) is a risk assessment clinical interview framework. Two assumptions:

people rarely kill themselves without engaging in concrete planning and making plans to do so

clients may not voluntarily come forward with information about their suicidal thoughts without a lot of rapport building on the part of the interviewer

The Reasons for Living scale (RFL) queries a person’s reasons for staying alive by posing 48 questions as to why people would not kill themselves

The Suicide Risk Assessment Decision Tree is a risk assessment clinical interview framework that moves through a series of yes-or-no questions to come to a decision about how present and pronounced is the person’s acquired capability of killing themselves.

previous suicidal behavior, current suicidal symptoms, and empirically related variables that would exacerbate (hopelessness, impulsivity) or diminish (engaging with social supports, stopping drug abuse) suicidal behavior.

Perturbation

The degree to which the individual is upser

combined with how oriented the person is toward death, lethality level rises, and the person be- comes more prone to suicide or homicide.

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