In the article, Addressing hopelessness in people with suicidal ideation: building upon the therapeutic relationship utilizing a cognitive behavioural approach by Collins and Cutcliffe, they focused their study to those who will attempt or attempted suicide. Further elaborate in this study is how to identify if a patient is in suicidal state, and how can this be prevented by the health care professional in dealing with this kind of scenario. Suicide is believed to be an act that stems from depression such as loss of a loved one, loss of body integrity or status, poor self-image and can be viewed as a cry for help and intervention.
Males are at greater risk than females. Others at risk are elderly people; young adults; people who are enduring unusual loss or stress; those who are unemployed, divorced, widowed or living alone; those showing signs of significant depression such as weight loss, sleep disturbances, somatic complaints, suicidal preoccupation; and those with a history of a previous suicide attempt suicide attempt, suicide in the family or psychiatric illness. The suicide rate of adolescents has increased drastically, with suicide being more prevalent in adolescents than in other age group.
Many suicides may actually be mistaken for accidental death (Automobile accidents, combining alcohol and barbiturates or discharging a gun while cleaning it). Suicide may results from problems with close relationship such as those with marriage partners or parents or from depression related to perceived occupational, academic or financial failure. In general, suicide result’s from the young adult’s inability to cope with the pressures, responsibilities and expectations of adulthood. Although females attempt suicide more often than males, males are more likely to succeed.
Depression is a possible contributing factor. Verbal or nonverbal indicators of suicide should not be ignored; rather an immediate referral should be made to a professional trained in suicide intervention. The nurse’s role in the prevention of suicide includes identifying behaviors that may indicate potential problems: depression; a variety of physical complaints, including weight loss, sleep disturbances and digestive disorders; and decreased interest in social and work roles along with an increase in isolation.
A young adult identified as at risk for suicide should be referred to a mental health professional or crisis center. Nurses can also reduce the incidence of suicide by participating in educational programs that provide about the early signs of suicide Being aware of the people risk and assessing for the specific factors that predispose a person to suicide are key management strategies. Specific signs and symptoms of potential suicide include the following: Communication of suicidal intent, such as preoccupation with death or talking of someone else’s suicide such as “I’m tired of living.
I’ve put my affairs in order. I’m better off dead. I’m a burden to my family” , any history of previous suicide attempt (the risk is much greater in these cases). Family history of suicide, loss of parent at an early age, specific plan for suicide, a means to carry out plan. The patient modify his suicidal plan. The patient might feels satisfied and detached fro his or her family and the patient accomplishes the last will and testament like of giving his or her valuables things to others.. It is important for us to deal with this kind of people.
There are identified salient points that are important in the process of suicidal attempt. In dealing with this kind of people, we must approach in a confrontational manner, and directly to the client like of “do you have plans of committing suicide? ”. We must also be aware (be vigilant) of the time especially in the endorsement period and early morning. Since suicidal patient are frequently plan in commiting suicide, It is said that visitation hours should be in irregular interval (one to one supervision is a must), so that these suicidal patient cannot do or make plan in attempting suicide.
We must also develop a formal “no suicide” contract with the patient’s stating “I wont hurt or kill myself accidentally or intentionally for 24 hours and also we must remove all hazardous objects form the belongs of the patient like of beit. Therapeutic communication is important measures in relieving the patient from suicidal attempt, as a health care provider, we must know and assessed to the patient what are his specific plans for suicide, how lethality of suicide method, the availability of the method and the presence of the support system.
Emergency management focuses on treating the consequences of the suicide attempt like of gunshot wound or drug overdose and preventing further self-injury. A patient who has made a suicidal gesture may do so again. Crisis intervention is employed to determine suicidal potential, to discover areas of depression and conflict, to find out about the patient’s support system, and to determine whether hospitalization or psychiatric referral is necessary.
Depending on the patient’s potential for suicide, the patient may be admitted to the intensive care unit, referred for follow-up care or admitted to the psychiatric unit.
Reference
Collins S. and Cutcliffe J. , (2003), Addressing hopelessness in people with suicidal ideation: building upon the therapeutic relationship utilizing a cognitive behavioural approach, Journal of Psychiatric and Mental Health Nursing, Blackwell Publishing Ltd, 10, 175–185