Suicide

 

Definition:

 Suicide is an act with a fatal outcome that is deliberately initiated and performed by the person in the knowledge or expectation of its fatal outcome. 

Or

A person when taken his / her life by self-destruction is called suicide.

 

 

 

Causes of suicide

 

1.    Serious conflicts and pressure.

2.    Successive failure in examination.

3.    Marriage against will.

4.    Chronic illnesses.

5.    Impotence.

6.    Diminished competence.

7.    Poor self-image.

8.    Vulnerability to loss of a loved one.

9.    Increased access to medication.

 

 

 

 

Risk factors for suicide

 

1.    Untreated mental disorders.

2.    History of previous suicide attempt.

3.    Alcohol and other substance use disorders.

4.    Unemployed.

5.    Family history of suicide or mental disorders.

6.    Family and domestic violence.

7.    Having guns in the home.

8.    Being male.

9.    Chronic physical illness.

10.  Recent or serious loss e.g., death, divorce, separation, broken relationship etc.

11.  Child abuse or neglect.

 

 

Methods of committing suicide

1.   1. Low lethal methods:

 

a)   Self-poisoning by pill ingestion.

b)   Wrist cutting.

c)    Inhaling dangerous gas.

 

2.  2.  High lethal methods :

 

a)   Gun shooting.

b)   Hanging.

c)    Drowning.

d)   Consuming high doses of barbiturates.

e)    Car crash.

f)     Fire arms.

g)    Jumping from high places.

h)   Falling in front of a moving vehicle.

 

 

Signs and Symptoms of Suicide

1.    Giving away prized possessions.

2.    Talking about death, dying.

3.    Using phrases such as “when I’m gone…” or “I’m going to kill myself”.

4.    Getting affairs in older.

5.    Saying goodbye to loved ones or family members.

6.    Obtaining items needed for suicide attempt.

7.    Increasing drug and alcohol usage.

8.    Withdrawing from once-pleasurable activities.

9.    Scars or injuries from past suicide attempts.

10.     Weight loss.

11.     Feeling helpless.

12.     Psychosis.

13.     Hopelessness.

14.     Suicide messages.

15.     Severe anxiety and agitation.

 

 

Effects of Suicide

1.    Severe injury

2.    Damage to all organ systems

3.    Brain damage

4.    Brain death

5.    Seizures

6.    Coma

7.    Death

 

 

Management of suicidal patient

 

1.    Adequate staffing.

2.    Vigilance.

3.    Special nursing arrangement to avoid keeping alone.

4.    In case of adolescents, limit the friend circle.

5.    Conduct suicide assessment, lethality plan.

6.    Engage the client in purposeful activities by diverting the mind.

7.    Provide symptomatic psychotherapeutic treatment.

8.    Regular review of risk and clear plan for leave.

9.    If client leaves ward without information, take immediate action.

10.                    Remove objects which might be used as a means of suicide.

11.                    Teach better problem solving techniques.

 

 

Preventive measures of suicide

 

1.    Frequent observation.

2.    Environment should be kept free from potential danger e.g. belts, razor blades, scissors and other sharp objects.

3.    Keep the ward drugs in cupboard under lock and key.

4.    Search him and his belongings if the patient leaves the ward.

5.    Keep a detailed written description of suicidal precautions.

6.    Patient should not be left alone even in the bathroom.

7.    Let the patient know that his stressful situation is acknowledged and he will receive support.

8.    Teach him coping skills.

9.    Discuss with the patient about his suicidal thought, suicidal plans that may reduce his anxiety.

10.       Look for suicidal clues.

11.       Establish a "no suicidal contract".

12.       Explore patient's strengths.

13.       Promote decision making ability in him.

14.       Convey the feelings of acceptance and belonging.