APNA 29th Annual Conference Session 3011.2: October 30, 2015 Applying - - PDF document

APNA 29th Annual Conference Session 3011.2: October 30, 2015 Puntil 1

Applying Psyc hiatr ic Nur se E sse ntial Compe te nc ie s for Asse ssme nt and Manage me nt of Individuals at R isk for Suic ide Competenc y number 4: How to distinguish war ning signs fr

• m r

isk fa c tor

s ! Che ryl Puntil, MN, APRN, PMHCNS,BC

T his spe a ke r ha s no t c o nflic t o f inte re st to disc lo se

Ob je c tive s

De fine a nd de sc rib e the diffe re nc e b e twe e n wa rning sig ns a nd risk fa c to rs I de ntify a nd e va lua te wa rning sig ns a s we ll a s risk a nd pro te c tive fa c to rs using c a se vig ne tte s

Suic ide risk a sse ssme nt is a multi-la ye re d a ppro a c h whic h invo lve s le a rning a b o ut a pe rso n, re c o g nizing his/ he r ne e ds, stre sso rs a nd sympto ms a nd e ng a g ing him/ he r to mo b ilize c o ping stra te g ie s a nd suppo rts (pro te c tive fa c to rs)

APNA 29th Annual Conference Session 3011.2: October 30, 2015 Puntil 2

De finitio ns

 R

isk F ac tor s- re fe r to pe rso na l o r e nviro nme nta l c ha ra c te ristic s tha t a re a sso c ia te d with suic ide . T he e nviro nme nt inc lude s so c ia l a nd c ultura l e nviro nme nt a s we ll a s the physic a l e nviro nme nt. (SAMHSA, 2012)

 War

ning Signs- a re fa c to rs tha t ma y se t into mo tio n the pro c e ss o f suic ide in the sho rt te rm ( ie : minute s a nd da ys) Wa rning sig ns pre se nt ta ng ib le e vide nc e to the c linic ia n tha t a pe rso n is a t a he ig hte ne d risk o f suic ide in the sho rt te rm.

War ning Signs within R isk F ac tor s

Risk F a c to rs

 Une mplo ye d o r re c e nt fina nc ia l diffic ultie s  Divo rc e d, se pa ra te d , wido we d  So c ia l iso la tio n  Chro nic me nta l illne ss  Chro nic , de b ilita ting physic a l illne ss  Prio r tra uma tic life e ve nts o r a b use  Pre vio us suic ida l b e ha vio r

APNA 29th Annual Conference Session 3011.2: October 30, 2015 Puntil 3

Na ture o f Suic ida l T hinking :

Ge t Spe c ific s!

 Ideation:

 Frequency, intensity/severity, duration, specificity

 Presence – can be useful

Absence less useful

 Relationship to intent to die

 Method:

 Availability/Accessibility  Multiple methods

 Active behaviors

 Preparation and rehearsal

WAR NING SIGNS

Pe rlma n CM, Ne ufe ld E , Ma rtin L , Go y M, & Hirde s JP (2011).

Ca se e xa mple -

R isk F ac tor s Une mplo ye d Divo rc e d, se pa ra te d , wido we d War ning Signs I nc re a sing ly ho pe le ss Bing e drinking e a c h we e ke nd E xpre ssing tho ug hts tha t the wo rld wo uld b e b e tte r o ff with o ut him T HOUGHT S o n wha t c o uld b e wa rning sig ns?

APNA 29th Annual Conference Session 3011.2: October 30, 2015 Puntil 4

T e st yo ur kno wle dg e

Whic h o f the fo llo wing pa tie nts wo uld b e a t mo st immine nt risk o f suic ide ?

a . A 22 ye a r o ld fe ma le who vo ic e s no re a so n fo r living , is re c e ntly une mplo ye d, a nd ha s a dia g no sis o f Bipo la r I Diso rde r. b . A 55 ye a r o ld ma le who thre a te ns to e nd his life e ve ry time he b ing e drinks with his frie nds. c . A 65 ye a r o ld fe ma le who is a nxio us, ha s diffic ulty sle e ping , a nd ha s c hro nic pa in.

• d. A 40 ye a r o ld ma le who e xpre sse s a wish to die , withd ra ws fro m fa mily,

a nd is ho pe le ss a nd drive s a t hig h ra te s o f spe e d da ily o n his wa y ho me trying to de c ide whic h tre e will b e the o ne he use s to e nd his life with.

Re fe re nc e s

APNA Psyc hia tric -Me nta l He a lth Nurse E sse ntia l Co mpe te nc ie s fo r Asse ssme nt a nd Ma na g e me nt o f I ndividua ls a t Risk fo r Suic ide re trie ve d 10-6-2015 fro m: http:/ / www.a pna .o rg / file s/ p ub lic / Re so urc e s/ Suic ide %20Co mpe te nc ie s%20f

• r%20Psyc hia tric -Me nta l%20He a lth%20Nurse s(1).p d f

Pe rlma n CM, Ne ufe ld E , Ma rtin L , Go y M, & Hirde s JP (2011). Suic ide Risk Asse ssme nt I nve nto ry: A Re so urc e Guide fo r Ca na dia n He a lth c a re Org a niza tio ns. T

• ro nto , ON: Onta rio Ho spita l Asso c ia tio n a nd Ca na dia n

Pa tie nt Sa fe ty I nstitute . Sub sta nc e Ab use a nd Me nta l He a lth Se rvic e s Administra tio n. Pre ve nting Suic ide : A T

• o lkit fo r Hig h Sc ho o ls. HHS Pub lic a tio n No . SMA-12-4669. Ro c kville , MD:

Ce nte r fo r Me nta l He a lth Se rvic e s, Sub sta nc e Ab use a nd Me nta l He a lth Se rvic e s Administra tio n, 2012. Suic ide Pre ve ntio n Re so urc e Ce nte r: Suic ide Asse ssme nt F ive -Ste p E va lua tio n a nd T ria g e fo r Me nta l He a lth Pro fe ssio na ls SAF E

• T

www.sprc .o rg / lib ra ry/ sa fe _t_p c ktc rd_e d c .p d f