Delimma of Suicide

Suicide is taking one’s own life with intention to die. Death could result for not having proper knowledge and underestimating the lethality of the attempt, when in actual the intent was not to die but self harm.

Self harm is try to hurt oneself overtly or covertly, ranging from as minor as nail scratch to actually killing self, but the intent was not to die .

~Suicide is 3rd leading Cause of death among 10 to 24 years (As per centre for disease control and prevention)

• Suicide in young children is more likely to be related to family dysfunction, physical abuse, substance abuse, mood disorder and or schizophrenia. Suicidal behavior during childhood significantly increases the risk that suicide will be completed in adolescence.
• Statistics
• WHO Report published in 2005 (there are 877,000 suicide occur worldwide annually)

Approximately 200,000 suicides occur between ages of 15 to 25 years.

90%having some sort of mental illness majority constituting depression.

Experts suggested the possibility of increased use of antidepressants has helped overall suicidal rate decrease during 1990 to 2004.

At least 25 suicide attempts documented for each completed suicide.

Male completed suicide is 4 times of female completed suicide. However Female suicide attempts are more frequent then male but completed suicide is same for male and female.

Suicide: Intent to die.

Self Injurious Behavior: Intent is not to die, (However accident can happen).

• Factors that can increase future risk of Suicide.
• Mood disorders
• Familial psychiatric diagnoses
• History of abuse
• Past suicide attempts
• Copycat suicide
• Presence of a lethal means of suicide.
• Change in eating and sleeping habit.
• Emotional distress and frequent physical complaints.
• Risk taking and impulsive behavior
• Does not respond to praise like before.
• Express bizarre unsettling thoughts.
• Suicide notes
•  Statements like ” I will not trouble you anymore”
•  “I want you to know something, in case something happens to me”
• How to identify and prevent the Youth at risk?
• Educational program for Mental illness and learning disorders.
• Treatment of underlying mental illness like depression psychosis etc.
• Addressing substance abuse problems.
• Learning how to deal with life stresses.

Appropriate treatment plan after suicide attempt

First Understand suicide is Cry for help.

Try to get the Psychiatric evaluation to find the underlying cause.

It might be a challenge to bring the Suffering youth to the Physician’s office.

Offer support and understanding.

Showing unconditional love is necessary.

Treat the underlying cause.

Help learn to deal with stressful life events

Assess severity and circumstances of suicide attempt.

Assessment about overall medical health and symptoms.

Tolerance to the procedure medication and therapy.

Availability of the treatment modality.

Parents and youth’s point of view about the attempt and understanding the treatable causes and treatment options is vital.

Each youth needs individualized evaluation and treatment plan which best suits the need

After full evaluation of home and family environment need is to develop focused treatment plan.

Individual Therapy.

Family Therapy.

Medication treatment.( SSRI’s, Atypical Antipsychotics, Mood stabilizers etc)

Hospitalization if needed for safety and treatment.

Treat the underlying cause of suicide attempt.

Prevention strategies for future attempt

Is every suicide attempt requires evaluation?

YES

However treatment option and modalities greatly depend on many factors.

Is attempt was after prolonged depression or other mental illness?

Is it an impulsive act or planned?

Means which were used for suicide?

Was there anyone around when attempt was made?

Presence or absence of remorse, Like happy to survive or not?

Was this a suicide result of suicide pact or solo attempt?

Intensity and severity of stressful life situation.

Reference:

• Teen suicide” Ohio state medical centre
• onlineJ Psychiatr Res. 2011 Jul;45(7):863-70. Epub 2011 Jun 1.
• 3 Table of WHO suicide rates by gender as of December 2005
• “Teen Suicide Statistics”. Adolescent Teenage Suicide Prevention.
• FamilyFirstAid.org. 2001. http://www.familyfirstaid.org/suicide.html. Retrieved 2006-04-11.
•  The Werther effect after television films: new evidence for an old hypothesis, Psychol Med. 1988 Aug;18(3):665-76.
•  “Preventing suicide: A report for media professionals” (PDF). World Health Organization. 2000.   http://www.who.int/entity/mental_health/media/en/426.pdf. Retrieved 2007-06-09
•  Hamzelou, J (2009). “Copycat suicides fuelled by media reports.”. Newscientist. http://www.newscientist.com/article/dn17889-copycat-suicides-fuelled-by-media-reports.html. Retrieved April 21, 2011