SUICIDE
Linet Hilsberg - RN, MHN,(cred), MPH, MMHN, GradDipH, GradDipMgt, GradCertNurs(Forens), GradCertBus(Mgt), Cert IV WTA
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Suicide has occurred since the beginning of recorded history, with attitudes toward it varying from condemnation to tolerance depending on the time and the culture, the motives for suicide and its frequency have also varied. Today in Western society, suicide is viewed as neither a random nor a pointless act. On the contrary, it is a way out of a problem or crisis that is invariably causing intense suffering.
Suicide is the voluntary act of killing oneself. It is sometimes called suicide completion. The behavioral definition of suicide is limited and does not consider the complexity of the underlying depressive illness, personal motivations, and situational and family factors that provoke the suicide act.
Para suicide is a voluntary, failed attempt to kill oneself. If is frequently called attempted suicide. Para suicidal behaviours vary by intent. (Ferreira de Castro, Cunha, Pimenta M, & Costa, 1998). For example, some people who attempt suicide truly wish to die, but others simply wish to feel noting for a while. Still others attempt suicide because they want to send a message to others about their emotional state.
Suicidal ideation is thinking about and planning one’s own death, it also includes excessive or unreasoned worrying about losing a significant other.
Although mental illness is stigmatized in today’s society, suicide is especially so. Speaking about or attempting suicide makes mental illness obvious to thers. This is especially true if the person who attempted suicide requires medical intervention or psychiatric hospitalization. The subsequent visibility of the disorder discredits the person, leaving him or her open to stigmatizations (Joachim & Acorn, 2000). The act of suicide stimulates others’ fears of the mentally ill because of the common belief that the mentally ill are violent (Link, Phelan, Bresnahan, Stueve, & Pescosolido, 1999; Steadman et al., 1998) reports and portrayals of suicide in the press and on TV also contribute to the stigmatization of those who consider or attempt suicide (Coverdale, Naim & Claasen, 2002). Society’s unwillingness to talk openly abbot suicide contributes to the common misperceptions that firearms are used more often to commit murder than suicide.
HOPLESSNESS
Is a state of despair characterized by feelings of inadequacy, isolation and inability to act on one’s own behalf, it is connected with the belief that one’s situation is unlikely to improve.
Suicidal behaviors are direct consequences of certain mood disorders, especially recurrent major depressive disorder which is common now days. The concurrence of suicide and mood disorders is important because suicide prevention is based, in part, on understanding the nature and occurrence of mood disorders.
Suicide is highly preventable, people commit suicide because others do not recognize the signs, underlying mood disorders are not treated, or those with suicidal ideation fear the social stigma of discussing their problems.
DETERMINING RISK
To assist a person who you may feel may be at risk, there are some questions that can be asked. Society today does not like to talk about these in case the person, by talking about ‘it’ actually does commit suicide.
If a person is unwell enough and has a set plan, has attempted suicide previously then discussing suicide with them may just help them open up to talk about whatever the problem is that is bothering them.
When a person presents at a doctor’s office with low mood, a risk screen is done to determine if the person is contemplating harming themselves. Questions that are asked are about the intention to die, these could include
Have you been thinking about hurting or killing yourself?
How seriously do you want to die?
Have you attempted suicide before?
Are there people or things in your life who might keep you from killing yourself?
To gauge an idea of how severe the thoughts are:
How often do you have these thoughts?
How long do they last?
How much do the thoughts distress you?
Can you dismiss them or do they tend to return?
Are they increasing in intensity and frequency
To get an idea of the planning of the act:
Have you make any plans to kill yourself? If yes, what are they?
Do you have access to the materials, (eg rope, guns pills) that you use to kill yourself?
How likely is it that you could actually carry out the plan?
Have you done anything to put the plan into action?
Could you stop yourself from killing yourself?
EFFECT ON SURVIVORS
It is said that one suicide is estimated to leave six survivors. Suicide has a devastating affect on everyone it touches especially family and close friends. Undue and prolonged suffering can be caused by the sudden shock, the unanswered questions of “why” and potentially the discovery of the body. (Kneiper, 1999). Suicide bereavement is different than that experienced by families whose loved one’s death is not self-inflicted. The grieving over the way the death occurred, the social processes affecting the survivor, and the effect of the suicide on the family converge to establish a grieving process that is unique.
These families reported more stigmatization, shame, and rejection than other families whose member died in other ways, they also reported police, coroners, and the media exacerbated their grief by their insensitivity.
Coping abilities do mediate grief responses, although recovery from a loved one’s suicide is an ongoing task, survivors who are emotionally healthy before the suicide act and who have social supports are able to manage the psychological trauma associated with suicide.
If someone you know has experienced this, please have some compassion and understanding.
References:
Kaplan & Sadock’s Synopsis of Psychiatry Behavioral Sciences/Clinical
Psychiatry 9th ed (2003) Lippincott Williams & Wilkins Philadelphia
Gorman J.M, section ed. Anxiety disorders, In: Sadock, B.J, Sadock V.A eds. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. 7th ed Vol 1 Baltimore; Lippincott Williams & Wilkins; 2000: 1441
Boyd, M.A Psychiatric Nursing Contemporary Practice Lippincott Williams & Wilkins Sydney 2004 pp 864 |
