Suicide Presentatioin
Transcript of Suicide Presentatioin
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Adolescent SuicideAdolescent Suicide
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FactsFacts
Suicide is the thirdSuicide is the third--leading cause ofleading cause ofdeath in adolescentsdeath in adolescents
Between 6 and 13 percent of adolescentsBetween 6 and 13 percent of adolescentsattempt suicide at least once during theirattempt suicide at least once during theirteenage yearsteenage years
Mostly due to psychological disordersMostly due to psychological disorders(90%)(90%)
DepressionDepression
Also, due to substance abuseAlso, due to substance abuse
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Myths, Cont.Myths, Cont.
Once signs of improvement are shown,Once signs of improvement are shown,
the danger is over. WRONG!the danger is over. WRONG!
Once a person fails, he/she will never tryOnce a person fails, he/she will never try
again. WRONG!again. WRONG!
Past attempts predict future attemptsPast attempts predict future attempts
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Detecting Teens at RiskDetecting Teens at Risk
Clues may be direct or indirectClues may be direct or indirect
May be verbal or behavioralMay be verbal or behavioral
When determining if a teen is at risk,When determining if a teen is at risk,
eliminate all mythseliminate all myths
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Verbal CluesVerbal Clues
Most obvious of warning signsMost obvious of warning signs
Indirect clues:Indirect clues:
I cant take it anymore!I cant take it anymore!
Youll miss me when Im gone.Youll miss me when Im gone.
I wont be here when you return.I wont be here when you return.
Direct clues:Direct clues:
I want to die.I want to die.
Im going to kill myself.Im going to kill myself.
If this happens again, Im going to end it all.If this happens again, Im going to end it all.
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Behavioral CluesBehavioral Clues
Indirect clues:Indirect clues:
Giving away prized possessionsGiving away prized possessions
Making a willMaking a will
Saying goodSaying good--bye to family and friendsbye to family and friends
Extreme cases of: irritability, guilt, and cryingExtreme cases of: irritability, guilt, and crying
Direct clues:Direct clues: Failed suicide attemptsFailed suicide attempts
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Failed Suicide Attempt
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Intervention: What to DoIntervention: What to Do
No kill contractNo kill contract promising not to inflictpromising not to inflict
harm upon oneselfharm upon oneself
Remove anything accessible toRemove anything accessible to
adolescent that may cause harmadolescent that may cause harm
Guns, Ammunition, Pills, Ropes, SharpGuns, Ammunition, Pills, Ropes, Sharp
ObjectsObjects Watch at all timesWatch at all times
If out of control, institutionalizeIf out of control, institutionalize
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Intervention: What Not toIntervention: What Not to
DoDo Honesty is the best policyHonesty is the best policy
Do not be falsely reassuring, ex. Telling theDo not be falsely reassuring, ex. Telling the
adolescent that everyone loves him,adolescent that everyone loves him,everyone is his friend, etc.everyone is his friend, etc.
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Adolescent ImpactAdolescent Impact
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Adolescent ImpactsAdolescent Impacts
Suicidal behavior is the end result of aSuicidal behavior is the end result of a
complex interaction of psychiatric, socialcomplex interaction of psychiatric, social
and family factors.and family factors.
Some social changes might be related toSome social changes might be related to
the rise in adolescent suicide.the rise in adolescent suicide.
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Stressful Events that canStressful Events that can
Trigger Suicidal Behavior Trigger Suicidal Behavior Previous suicide attempts.Previous suicide attempts.
A family member that has committed suicide.A family member that has committed suicide.
Recent lossesRecent losses: Death of someone close to you,: Death of someone close to you,
divorce in the family, or relationship break up.divorce in the family, or relationship break up.
Social isolationSocial isolation: Having no social alternative.: Having no social alternative.
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Stressful Events that canStressful Events that can
Trigger Suicidal BehaviorTrigger Suicidal Behavior
contcont Drug or alcohol abuseDrug or alcohol abuse: Drugs and alcohol: Drugs and alcohol
decrease impulse control and some individualsdecrease impulse control and some individualstry to selftry to self--medicate their depression with drugsmedicate their depression with drugsor alcohol.or alcohol.
Exposure to violence:Exposure to violence: In the home or theIn the home or the
social environment: The individual sees violentsocial environment: The individual sees violentbehavior as a viable solution to life problems.behavior as a viable solution to life problems.
Having knives/machetes/swords/handgunsHaving knives/machetes/swords/handguns
at home.at home.
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Suicide has apowerful effect onSuicide has apowerful effect on
the individuals family, school andthe individuals family, school and
community.community.
Anyone close to someone who hasAnyone close to someone who has
committed suicide may ex
periencecommitted suicide may ex
perience FearFear
RageRage
GuiltGuilt DepressionDepression
DisbeliefDisbelief
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ContCont
ShockShock
SelfSelf--DoubtDoubt
They may feel responsible for notThey may feel responsible for not
recognizing the signs.recognizing the signs.
Feel Angry at the victim for desertingFeel Angry at the victim for deserting
themselves.themselves.
A feeling of loss and emptiness.A feeling of loss and emptiness.
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ImpactImpact
Adolescents may often support a suicidal friendAdolescents may often support a suicidal friend
by themselves. If they do not try to get theirby themselves. If they do not try to get their
friend help and then they commit suicide, thefriend help and then they commit suicide, the
adolescent will feel a tremendous burden ofadolescent will feel a tremendous burden ofguilt and failure.guilt and failure.
It is very important for teens to listen to suicidalIt is very important for teens to listen to suicidal
youth in an empathetic way but they shouldyouth in an empathetic way but they should
also make sure that they report suicidalalso make sure that they report suicidalstatements to a responsible adult to make surestatements to a responsible adult to make sure
that the teen can obtain help.that the teen can obtain help.
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*Recovery from loss may take*Recovery from loss may take
years.years.--There are intense feeling thatThere are intense feeling that
have to be worked through ashave to be worked through as
they accept the loss.they accept the loss.
Impact, Cont.Impact, Cont.
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CopycatCopycat SuicideSuicide
Where one person commits suicide andWhere one person commits suicide and
this gives permission for others tothis gives permission for others to
commit suicide too.commit suicide too.
This is especially true when the suicide isThis is especially true when the suicide is
getting a lot of attention from the media.getting a lot of attention from the media.
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Continuity ofContinuity of
Adolescent SuicideAdolescent Suicide
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Risk Levels of SuicidalRisk Levels of Suicidal
AdolescentsAdolescents
Low Risk Teens:Low Risk Teens:
May joke about suicide from time to time.May joke about suicide from time to time. Repeatedly seek treatment of similar somaticRepeatedly seek treatment of similar somatic
complaintscomplaints
High Risk Teens:High Risk Teens: A comprehensive plan including the method, place,A comprehensive plan including the method, place,
time, and clear intent.time, and clear intent.
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Treatment Options forTreatment Options for
Low Risk TeensLow Risk Teens A thorough assessment of the adolescents concernsA thorough assessment of the adolescents concerns
should be performed by a Pediatrician or ashould be performed by a Pediatrician or aChild/Adolescent Psychologist.Child/Adolescent Psychologist.
A followA follow--up appointment with the evaluator should beup appointment with the evaluator should bearranged to establish a treatment plan and check thearranged to establish a treatment plan and check theteens progress with that treatment plan.teens progress with that treatment plan.
EVEN LOW RISK SUICIDAL TEENS SHOULDEVEN LOW RISK SUICIDAL TEENS SHOULDRECEIVE PROPER MEDICAL ATTENTION TORECEIVE PROPER MEDICAL ATTENTION TO
PREVENT THE CONDITION FROM WORSENING.PREVENT THE CONDITION FROM WORSENING.
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Treatment of High RiskTreatment of High Risk
TeensTeens Contact a mental health professionalContact a mental health professional
IMMEDIATELY!!IMMEDIATELY!!
There are several options for immediateThere are several options for immediateevaluation of suicidal teens:evaluation of suicidal teens:
Emergency RoomEmergency Room
HospitalizationHospitalization Same daySame dayappointment with a mental healthappointment with a mental health
professional.professional.
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Continued Treatment ofContinued Treatment of
High Risk TeensHigh Risk Teens A comprehensive emotional and psychosocialA comprehensive emotional and psychosocial
evaluation must be completed prior to discharge fromevaluation must be completed prior to discharge fromthe hospital.the hospital.
Family Members should also be interviewed to helpFamily Members should also be interviewed to helpdefine further explanations of the teens attempt.define further explanations of the teens attempt.
Teachers and family friendsTeachers and family friends maymayalso provide helpfulalso provide helpfulinformation about the teen.information about the teen.
Intervention should fit the teens needs.Intervention should fit the teens needs. Pediatricians can enhance the continuity and compliance ofPediatricians can enhance the continuity and compliance of
the treatment by keeping regular contact with the suicidal teenthe treatment by keeping regular contact with the suicidal teenafter making referrals.after making referrals.
ALL FIREARMS SHOULD BEALL FIREARMS SHOULD BE REMOVEDREMOVED FROM THEFROM THEHOUSE IN WHICH THE TEEN RESIDES!!HOUSE IN WHICH THE TEEN RESIDES!!
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Crisis Control Within theCrisis Control Within the
SchoolSchool Schools often ask pediatricians to report to theSchools often ask pediatricians to report to the
school to provide crises control.school to provide crises control. Provide medical information about the cause ofProvide medical information about the cause of
death as well as explain health implications from andeath as well as explain health implications from anattempted suicideattempted suicide
Help the nurse attend somatic complaints of theHelp the nurse attend somatic complaints of theteens fellow classmatesteens fellow classmates
Reports the incident to fellow pediatricians, raisingReports the incident to fellow pediatricians, raisingtheir vigilancetheir vigilance
It is important to remember that no interventionIt is important to remember that no interventionhas been proven to predict or prevent suicide.has been proven to predict or prevent suicide.
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A Few QuestionsA Few Questions
Following Teen SuicideFollowing Teen Suicide Who should be involved in responding to the teenWho should be involved in responding to the teen
suicide? To do what?suicide? To do what?
Who should be told about the event? When?Who should be told about the event? When?
What should they be told?What should they be told?
Funeral?Funeral?
If the suicide occurred within the school, how shouldIf the suicide occurred within the school, how shouldthe site be managed?the site be managed?
Should student suicide prevention curriculum beShould student suicide prevention curriculum be
instituted?instituted? How long should intervention and vigilance last afterHow long should intervention and vigilance last after
the tragedy?the tragedy?
Memorial? Anniversary?Memorial? Anniversary?
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Cultural Differences:Cultural Differences:
StatisticsStatistics In 1998, white males accounted for 61% of allIn 1998, white males accounted for 61% of all
suicides among youth age 10suicides among youth age 10--19.19.
White males and females accounted for overWhite males and females accounted for over84% of all youth suicides.84% of all youth suicides.
According to the Center for Disease Control, inAccording to the Center for Disease Control, in
2004 American Indian and Alaskan Natives2004 American Indian and Alaskan Natives
had the highest rate of suicide between thehad the highest rate of suicide between theages of 15ages of 15--24.24.
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Statistics, contdStatistics, contd
From 1981From 1981--1998, suicide rate increased most1998, suicide rate increased mostamong black males 10among black males 10--1919 Rate more than doubled from 2.9 per 100,000 to 6.1Rate more than doubled from 2.9 per 100,000 to 6.1
per 100,000.per 100,000. 1999 nationwide high school survey showed1999 nationwide high school survey showedHispanic students were almost two times moreHispanic students were almost two times morelikely than white students to have reported alikely than white students to have reported asuicide attempt (12.8% vs. 6.7%)suicide attempt (12.8% vs. 6.7%) Of the 12.8%, Hispanic females were almost threeOf the 12.8%, Hispanic females were almost three
times more likely than Hispanic males to havetimes more likely than Hispanic males to havereported a suicide attempt (18.9% vs. 6.6%)reported a suicide attempt (18.9% vs. 6.6%)
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Socio EnvironmentalSocio Environmental
DifferencesDifferences There are few differences in SES fromThere are few differences in SES from
the general population, except amongthe general population, except among
African Americans.African Americans.African American suicides tend to haveAfrican American suicides tend to have
higher SES than general black population.higher SES than general black population.
Those who attempt to commit suicide areThose who attempt to commit suicide areless like to attend college than sameless like to attend college than same--age,age,
samesame--sex general population.sex general population.
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GenderDifferencesGenderDifferences
Girls are more likely to attempt suicideGirls are more likely to attempt suicide
Boys are more likely to succeed Boys are more likely to succeed
Use more violent methodsUse more violent methods
Hanging, single vehicle car accidents, shootingHanging, single vehicle car accidents, shooting
or stabbing themselves, jumping from heightsor stabbing themselves, jumping from heights
Girls tend to use less violent methodsGirls tend to use less violent methods Taking pillsTaking pills
CuttingCutting
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FamiliesFamilies
Youth who commit suicide are to some extentYouth who commit suicide are to some extent
more likely to come from a broken home thanmore likely to come from a broken home than
are others of their same ethnic group.are others of their same ethnic group. However, about half lived with both biologicalHowever, about half lived with both biological
parents at time of deathparents at time of death
One mutual factor for most cases is poorOne mutual factor for most cases is poor
parentparent--childchild communication.communication.
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Families, contdFamilies, contd
High proportion of suicides and attemptedHigh proportion of suicides and attempted
suicides had a close family member or friendsuicides had a close family member or friend
who committed or attempted suicide.who committed or attempted suicide. Familial suicide could be in part due to imitation orFamilial suicide could be in part due to imitation or
genetics.genetics.
If risk of suicide is genetic, it is unclear whether it isIf risk of suicide is genetic, it is unclear whether it is
a predisposition to mental illness or an underlyinga predisposition to mental illness or an underlying
personality that is inherited.personality that is inherited.
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SourcesSources
Author Unknown. (Apr 2000). Suicide and Suicide Attempts in Adolescents.Author Unknown. (Apr 2000). Suicide and Suicide Attempts in Adolescents. PediatricsPediatrics,, Part 1Part 1
of 2, Vol. 105, Issue 4of 2, Vol. 105, Issue 4, 871, 871--875.875.
Popenhagen, Mark P. and Roxanne M. Qualley (Apr. 1998). Adolescent Suicide: Detection,Popenhagen, Mark P. and Roxanne M. Qualley (Apr. 1998). Adolescent Suicide: Detection,
Intervention, and Prevention.Intervention, and Prevention. Professional School Counseling, Vol. 1(4),Professional School Counseling, Vol. 1(4), 3030--36.36.
Rice, F. P. & Dolgin, K. G. (2005).Rice, F. P. & Dolgin, K. G. (2005). The adolescent: Development, relationships and cultureThe adolescent: Development, relationships and culture
(11th ed.).(11th ed.). Boston: PearsonBoston: Pearson