Suicidal Clients

Suicide is associated with thwarted or unfulfilled needs, feelings of hopelessness and helplessness, ambivelent conflicts between survival and unbearable stress, a narrowing of perceived options and a need to escape

Shneidman,1996

Suicide maybe a culmination of self-destructive urges that have resulted from the clients internalising his or her anger or a desperate act by which to escape a percieved intolerable psychological state or life situation. The client may be asking for help by attempting suicide, seeking attention or attempting to manipulate someone with suicidal behavior.

Schultz & Videbeck, 2002

Etiology:

Genetic and Biologic Theories – Genetic Markers – Relationship of Neurochemical Binding Sites– Twin and Adoption Studies

Sociological Theory Psychological Theories

– Theory of Parasuicidal Behavior– Other Psychological Factors

Individuals at risk of self destructive behavior: Clients with a psychiatric disorder Clients with alexithymia Clients with medical illnesses

– Euthanasia and PAS Adolescents High-risk population groups

– Ethnic minorities, homosexuals, incarcerated, elderly

– Divorced, separated, widowed, unemployed

– High-risk occupations: anesthesiology, psychiatry, dentistry

The Nursing Process:

Assessment Nursing Diagnosis Outcome Identification Planning Interventions

Cont: Implementation

– Establishment of a safe environment

• Suicide prevention

• Suicide precautions• No suicide contract• Seclusion and restraint

– Assistance in meeting basic human needs

– Medication management

– Interactive therapies

– Client and family education Continuum of care

– Special considerations: adolescent clients

– Interventions after a successful suicide attempt

• Psychological autopsy

• Postvention for bereaved survivors

Evaluation