Suicide, Para suicide and Risk Assessment

Size: px
Start display at page:

Download "Suicide, Para suicide and Risk Assessment"

Transcription

1 Suicide, Para suicide and Risk Assessment LPT Gondar Mental Health Group

2 Objectives: Definition of suicide, Para suicide/dsh Changing trends of methods used Epidemiology Clinical Variables Risks factors and assessment Case Scenarios

3 Suicide Definition. Suicide is not a diagnosis. It is a verdict / category of death in which the death was unnatural and result of the victim s own actions with the intention to kill him/herself.

4 Para suicide Definition An act with non-fatal outcome, in which an individual deliberately initiates a non habitual behaviour that, without intervention from others, will cause self-harm, or deliberately ingests a substance in excess of the prescribed or generally recognized therapeutic dosage

5 Deliberate Self Harm The behaviour is self-initiated harm is intended (intention to kill is low) results in injury or harm Two main types: self-poisoning self-injury

6 SUICIDE

7 Methods used are subject to trend and availability Violent methods more common in males more common in those with a mental illness e.g. Hanging and strangulation, drowning, throwing self in front of moving vehicles, firearm use.

8 Non-violent methods drug overdose, CO poisoning

9 World wide statistics 1 million people commit suicide worldwide each year. Most countries count suicide as being 1 of the top ten causes of death Among year olds suicide is reported as the 2nd or 3rd commonest cause of death.

10 Sex Distribution of Suicides In Britain suicides by hanging and by CO poisoning account for - 2 out of 3 male suicides - 1 out of 3 female suicides - Female suicide is more commonly via overdose male : female = 3:1 higher in young (15-24 yrs) and elderly males(>75) Main methods of suicide- hanging and poisoning by psychotropic drugs

11 Epidemiology Underestimated for a variety of reasons e.g. methods of reporting general population suicides occur per year in England and Wales. Approximately 25% of these people have been in recent contact with mental health services. Accounts for 1% of death from all causes

12 Epidemiology ( U.K data) The period of highest risk after discharge from in-patient care is the first 14 days Identified risk factors- being male, living alone, unemployment, drug and alcohol misuse, mental illness. Co morbidity, including substance misuse, and previous self harm are common.

13 SUICIDE: A MULTI-FACTORIAL EVENT Psychiatric Illness Co-morbidity Substance Use/Abuse Severe Medical Illness Personality Disorder/Traits Suicide Neurobiology Impulsiveness Hopelessness Family History Access To Weapons Psychodynamics/ Psychological Vulnerability Life Stressors Suicidal Behavior

14 Clinical Variables for Suicide Depression Lifetime risk of suicide is 15% (+) Main correlates include greater severity of illness self neglect hopelessness alcohol abuse Impaired concentration history of suicidal behaviour

15 Schizophrenia Lifetime risk of suicide 10-15% Main correlates: young and male relapsing pattern of illness past hx of depression Recent discharge inpatient to outpatient social isolation good insight into illness

16 Alcohol Abuse Lifetime risk is 2-4% Main correlates Male sex Longer duration of problems Single/divorced/widowed Currently drinking Presence of Depressive symptoms

17 Personality Disorder Evidence suggests that suicides associated with PD are nearly always associated with a depressive syndrome or substance abuse Lifetime risk of suicide under 10% reported. (Lower than depression or Schizophrenia)

18 Chronic Physical Illness The relative risk of committing suicide among patients with cancer is 2.5 Increased risk in patients with chronic neurological, gastro-intestinal, cardiovascular disorders Severe chronic pain leads to increased risk Disfigurement, especially in women

19 Chronic Physical Illness( Cont.) Chronic physical illness can lead to limitations including loss of job, role, family, money, etc Strong relationship between physical ill health and depression.

20 Social variables of Suicide Lower socio-economic status Unemployed Overcrowded Inner city areas Social deprivation Social isolation / single In custody

21 DELIBERATE SELF HARM

22 Epidemiology Underestimated 150,000 new attendances at A+E per year in E+W Higher rates in females Peak age yrs % of those with DSH ultimately die by their own hand

23 Risk of dying from suicide following DSH is 100X that of the general population 90% of DSH referred to general hospital involves drug overdose, usually with paracetamol or aspirin.

24 Motives Underlying DSH Wish to die Trial by ordeal Time out Cry for help Communication with others Unbearable symptoms

25 Associations with repeated self-harm Previous self-harm/ psychiatric contact Alcohol / Drug misuse Unemployment/ Social class V Personality disorder label Criminal record/ history of violence Age years Single / divorced / separated

26 Some psychological characteristics associated with self-harming behaviour: impulsivity dichotomous thinking cognitive rigidity problem-solving deficits autobiographical memory deficits hopelessness

27 Substance Abuse and DSH Alcohol use is reported in 50% of suicides Extensive use at time of DSH or just before DSH 40-75% males 12-50% females

28 Use of alcohol can add to the potential dangers of an OD Alcohol increases the toxicity of psychotropic drugs Alcohol alone can lead to unconsciousness and therefore delay time to treatment

29 Risk Factors - DSH and Suicide Demographic Age, gender, marital status, employment status Presentation Depression, schizophrenia, alcohol misuse, personality disorder

30 Risk Factors- continued Past psychiatric history previous history of DSH/ attempts of DSH Past medical illness- chronic illness Personal and social history- social variables, premorbid personality

31 Mental State Examination Depression Retardation Low mood Suicidal thoughts Negative cognition (hopelessness) Psychotic symptoms Lack of insight

32 Mental State Examination Schizophrenia - Positive psychotic symptoms, post psychotic depression, development of insight. Alcohol misuse Depression, psychosis and poor physical health.

33 DETERMINATION OF RISK Psychiatric Examination Risk Factors Modifiable Risk Factors Protective Factors Specific Suicide Inquiry Risk Level: Low, Med., High

34 HISTORY TAKING Detailed! When talking about the event remember to ask about INTENT Chronological - start with when did you first decide? Look at the preparation before the act - the sorting out of affairs, collecting of pills etc

35 HISTORY TAKING ( Cont.) Did anything happen to you that led to you wanting to kill yourself? Concealment of the act Was alcohol involved How were they found? How do they feel to be alive now? What would you do if you went home? Do you still want to kill yourself?

36 HISTORY TAKING ( Cont.) Have you done this before? Nothing predicts future behaviour as well as past behaviour Remember to ask about past psychiatric illness, comorbid substance abuse Current mental state - depression, psychosis etc Social support important if you are thinking of discharge

37 Case Scenario year old female was brought to A&E department following an overdose and self inflicted injuries. She took an overdose of 15 paracetamol tablets in front of her boy friend after having an argument with him. She is well known to psychiatric services and had several episodes of self harm in the last few years. Assess suicidal risk?

38 Case 2 A 67 year old widower was admitted to the acute psychiatric ward 3 days ago. He has been weepy and depressed for 4 months. He has significant weight loss and marked anhedonia. He lives on his own and has no family. He said he took alcohol occasionally. He expressed ideas of hopelessness and helplessness. He wanted to leave the hospital as he could not see any reason to be in hospital. You were asked to see the patient whether he could go home.

39 Case 3 A 21 year old young man had been diagnosed as suffering from schizophrenic illness a few months ago. He was admitted to hospital with acute psychotic symptoms, hallucinations and persecutory delusions, and also had problems of social withdrawal, impairment of self care and motivation. He responded well to treatment with olanzapine and was discharged from hospital 2 weeks ago. Now he presented with feeling depressed, withdrawn and also felt hopeless and helpless.he has insight into his illness. He expressed feeling demoralised. What will you do?

40 Case 4 A 55 year old lady is brought into A+E. She has MS and is wheelchair bound. Her husband who works away came home early to find that she had taken 120 paracetamol tablets that she receives from her GP for chronic pain. She has written letters to her family and states that she wants to be allowed to die. She refuses blood tests and parvolex. What will you do?

41 Provided by The Leicester Gondar Link Collaborative Teaching Project This work is licensed under a Creative Commons Attribution-NonCommercial- NoDerivs 3.0 Unported License.

Suicide A National Problem, What Every Physician Needs to Know!

Suicide A National Problem, What Every Physician Needs to Know! Suicide A National Problem, What Every Physician Needs to Know! Asim A. Shah M.D. Professor & Executive Vice Chair Menninger Department of Psychiatry, Professor, Department of Community and Family Medicine,

More information

Reading: Andreasen & Black, Introductory Textbook of Psychiatry, 3rd edition, Chapter 21, pp

Reading: Andreasen & Black, Introductory Textbook of Psychiatry, 3rd edition, Chapter 21, pp Psychiatry Sequence (PSY614) Topic: Faculty: Suicide Michael Jibson, M.D., Ph.D. Reading: Andreasen & Black, Introductory Textbook of Psychiatry, 3rd edition, Chapter 21, pp. 553-568 Lecture: Thursday,

More information

Suicide and suicidal behaviour in alcohol use disorders

Suicide and suicidal behaviour in alcohol use disorders Suicide and suicidal behaviour in alcohol use disorders Dr Julia Sinclair Senior Lecturer in Psychiatry University of Southampton Overview Suicide and suicidal behaviour Definitions Context: UK rates Risk

More information

Manchester Self-Harm Project MaSH

Manchester Self-Harm Project MaSH MaSH Manchester Self-Harm Project MaSH 6 th Year Report 1 st September 2002 to 31 st August 2003 Jayne Cooper, Amy Johnston, Maria Healey, Iain Donaldson, Harriet Bickley, Navneet Kapur, Louis Appleby

More information

Suicide Spectrum Assessment and Interventions. Welcome to RoseEd Academy. Disclaimer

Suicide Spectrum Assessment and Interventions. Welcome to RoseEd Academy. Disclaimer RoseEd Module 7 Suicide Spectrum Assessment and Interventions Suicide Spectrum Assessment and Interventions J. Scott Nelson MA NCC LPC CRADC Staff Education Coordinator Welcome to RoseEd Academy Disclaimer

More information

SUBJECT: Suicide Risk Screening and Assessment of Individuals in State Hospitals and State-Operated Crisis Stabilization Programs

SUBJECT: Suicide Risk Screening and Assessment of Individuals in State Hospitals and State-Operated Crisis Stabilization Programs DBHDD SUBJECT: Suicide Risk Screening and Assessment of Individuals in State Hospitals and State-Operated Crisis Stabilization Programs Policy: 03-504 Page 2 of 3 Hospital and CSP Staff Awareness regarding

More information

Dr Carmelo Aquilina Senior Staff Specialist & Service Director Sydney West Area Health Service Clinical Senior Lecturer, University of Sydney

Dr Carmelo Aquilina Senior Staff Specialist & Service Director Sydney West Area Health Service Clinical Senior Lecturer, University of Sydney Dr Carmelo Aquilina Senior Staff Specialist & Service Director Sydney West Area Health Service Clinical Senior Lecturer, University of Sydney A suicide Outline Part 1: understanding suicide Part 2: What

More information

The science of the mind: investigating mental health Treating addiction

The science of the mind: investigating mental health Treating addiction The science of the mind: investigating mental health Treating addiction : is a Consultant Addiction Psychiatrist. She works in a drug and alcohol clinic which treats clients from an area of London with

More information

Suggested Protocol for Resident Verbalizing Suicidal Ideation or Plan

Suggested Protocol for Resident Verbalizing Suicidal Ideation or Plan Suggested Protocol for Resident Verbalizing Suicidal Ideation or Plan Rationale: In the event a [resident] verbalizes suicidal thoughts or even a plan, the carer will know what steps to take for safety

More information

L;ve L;fe; Your story is not over yet.

L;ve L;fe; Your story is not over yet. L;ve L;fe; Your story is not over yet. Suicide is not as rare as some think. Who is more at risk? In the U.S., suicide rates are highest during the spring. Suicide is the 3rd leading cause of death for

More information

Suicide. Theories of suicide

Suicide. Theories of suicide Theories of suicide Suicide 1. Sociological hypothesis (Durkheim) a) Altruistic - for the good of country b) Egoistic - individual has lost social integration with the group c) Anomic - society undergoing

More information

Drug History Zopiclone 3.75mg ON PRN (Review Overdue) Clozapine 50mg OM and 75mg ON (Prescribed by the mental health team)

Drug History Zopiclone 3.75mg ON PRN (Review Overdue) Clozapine 50mg OM and 75mg ON (Prescribed by the mental health team) Doctor s Instructions Patient: Pradeep Singh Age: 28 years old Last Consultations Dr Fitzpatrick 1 week ago Admin Note: Script request for zopiclone declined as medication review overdue, advised to make

More information

Suicidality and Older Adults

Suicidality and Older Adults Suicidality and Older Adults Leo Sher, M.D. Associate Professor of Psychiatry Icahn School of Medicine at Mount Sinai Director, Inpatient Psychiatry James J. Peters Veterans Administration Medical Center

More information

Medication Management. Dr Ajith Weeraman MBBS, MD (Psychiatry), FRANZCP Consultant Psychiatrist Epworth Clinic Camberwell 14 th March 2015

Medication Management. Dr Ajith Weeraman MBBS, MD (Psychiatry), FRANZCP Consultant Psychiatrist Epworth Clinic Camberwell 14 th March 2015 Medication Management Dr Ajith Weeraman MBBS, MD (Psychiatry), FRANZCP Consultant Psychiatrist Epworth Clinic Camberwell 14 th March 2015 1 Medication Management Objectives: 1. Principles of psycho-pharmacology

More information

A Primer on Suicide Risk Assessment

A Primer on Suicide Risk Assessment www.joeobegi.com A Primer on Suicide Risk Assessment Joseph H. Obegi, PsyD October 14 OBJECTIVES Introduction Why do an SRA? When to do an SRA SRA process Accounting Risk factors Warning signs Protective

More information

4.Do a Mini Mental State Examination on your study buddy.

4.Do a Mini Mental State Examination on your study buddy. MCQ PYCHIATRIC DIORDER UAN TUCKER 1.High yield indicators of an organic illness include all of these except? a) disorientation b) rapid onset c) no pre morbid decline d) a score of 23 on Folsteins Mini

More information

ACOEM Commercial Driver Medical Examiner Training Program

ACOEM Commercial Driver Medical Examiner Training Program ACOEM Commercial Driver Medical Examiner Training Program Module 7: Psychological Psychological 49 CFR 391.41(b)(9) "A person is physically qualified to drive a commercial motor vehicle if that person

More information

MINDFUL WELLNESS CENTER, PLLC

MINDFUL WELLNESS CENTER, PLLC PATIENT HISTORY NAME DATE PLEASE TAKE YOUR TIME AND COMPLETE THE ENTIRE FORM. You may use the back if needed for more explanation. Identifying Information: Date of Birth: Age: Sex: Place of Birth: Religion:

More information

Session outline. Introduction to depression Assessment of depression Management of depression Follow-up Review

Session outline. Introduction to depression Assessment of depression Management of depression Follow-up Review Depression 1 Session outline Introduction to depression Assessment of depression Management of depression Follow-up Review 2 Activity 1: Person s story followed by group discussion Present the first person

More information

Schizophrenia is a serious mental health condition that affects

Schizophrenia is a serious mental health condition that affects Schizophrenia Schizophrenia is a serious mental health condition that affects a person s thoughts, feelings and behaviours. Whilst it is serious, schizophrenia is both treatable and manageable, and we

More information

ASAM Criteria, Third Edition Matrix for Matching Adult Severity and Level of Function with Type and Intensity of Service

ASAM Criteria, Third Edition Matrix for Matching Adult Severity and Level of Function with Type and Intensity of Service 1: Acute Intoxication and/or Withdrawal Potential Risk Rating: 0 1: Acute Intoxication and/or Withdrawal Potential Risk Rating: 1 1: Acute Intoxication and/or Withdrawal Potential Risk Rating: 2 The patient

More information

Frequent repeaters of self-harm: Findings from the Irish National Registry of Deliberate Self-Harm

Frequent repeaters of self-harm: Findings from the Irish National Registry of Deliberate Self-Harm Frequent repeaters of self-harm: Findings from the Irish National Registry of Deliberate Self-Harm E G r i f f i n 1, E A r e n s m a n 1, 2, P C o r c o r a n 1, 2, I J Perry 2 1 N A T I O N A L S U I

More information

NVDRS Mission. To collect high quality, detailed, timely information on all violent deaths in the US

NVDRS Mission. To collect high quality, detailed, timely information on all violent deaths in the US NVDRS Mission To collect high quality, detailed, timely information on all violent deaths in the US What is the NVDRS? A public health surveillance system Population-based Active Census designed to obtain

More information

Panic Disorder with or without Agoraphobia

Panic Disorder with or without Agoraphobia Panic Disorder with or without Agoraphobia LPT Gondar Mental Health Group www.le.ac.uk Panic Disorder With and Without Agoraphobia Panic disorder Panic versus anxiety Agoraphobia Agoraphobia without panic

More information

More than 1 million people die worldwide every year from suicide!!!

More than 1 million people die worldwide every year from suicide!!! Chapter 115 Suicide Episode Overview: 1) Name 10 risk factors for suicide 2) Name an additional 5 risk factors for adolescent suicide 3) Describe the SAD PERSONS scale 4) Describe 4 potential targeted

More information

P H I L L I P N. S M I T H, P H. D. C A N D I C E N. S E LW Y N, M. S.

P H I L L I P N. S M I T H, P H. D. C A N D I C E N. S E LW Y N, M. S. P H I L L I P N. S M I T H, P H. D. C A N D I C E N. S E LW Y N, M. S. U N I V E R S I T Y O F S O U T H A L A B A M A 2 2 O C T O B E R 2 0 1 4 A L J A I L A S S O C I AT I O N S A N N U A L C O N F E

More information

She has an extensive psychiatric history, with numerous admissions, and minor selfharm.

She has an extensive psychiatric history, with numerous admissions, and minor selfharm. Instructions for Candidates Scenario Rhona Anderson is a 28-year-old woman who has been referred for assessment by her GP. She had presented to her GP expressing suicidal ideation. She has an extensive

More information

Threat to Self: Suicide & Self-Injurious Behavior. David Towle, Ph.D. UNI Counseling Center Director

Threat to Self: Suicide & Self-Injurious Behavior. David Towle, Ph.D. UNI Counseling Center Director Threat to Self: Suicide & Self-Injurious Behavior David Towle, Ph.D. UNI Counseling Center Director What do you do? You check your e-mail and find a message from a student, apparently sent about 3 a.m.,

More information

Suicide in North Carolina and the Nation

Suicide in North Carolina and the Nation Suicide in North Carolina and the Nation Intentional Death Prevention Committee Child Fatality Task Force Injury Epidemiology and Surveillance Unit October 10, 2011 Today s Agenda Overview US and NC NC-Violent

More information

Mental health and motherhood. Why is this important? Are we doing enough? What more could we do?

Mental health and motherhood. Why is this important? Are we doing enough? What more could we do? Mental health and motherhood Why is this important? Are we doing enough? What more could we do? Why is this important? Why is this important? Why is this important? Why is this important? Confidential

More information

Suicide.. Bad Boy Turned Good

Suicide.. Bad Boy Turned Good Suicide.. Bad Boy Turned Good Ross B Over the last number of years we have had a few of the youth who joined our programme talk about suicide. So why with all the services we have in place is suicide still

More information

Directions: Use your mouse or the arrows on your keyboard to click through this tutorial.

Directions: Use your mouse or the arrows on your keyboard to click through this tutorial. Directions: Use your mouse or the arrows on your keyboard to click through this tutorial. Diamond Healthcare Corporation Suicide Risk Assessment For Outpatient Programs 2009 Objectives 1. Identify the

More information

UPMC SAFE-T Training Adapted for Pediatric Primary Care. Sheri L. Goldstrohm, Ph.D.

UPMC SAFE-T Training Adapted for Pediatric Primary Care. Sheri L. Goldstrohm, Ph.D. UPMC SAFE-T Training Adapted for Pediatric Primary Care Sheri L. Goldstrohm, Ph.D. Prevalence of Suicide in the U.S. 10th most frequent cause of death for all ages 2nd leading cause of death for individuals

More information

Risk factors associated with alcohol related self-harm and suicide: New insights and improving evidence based policy and practice

Risk factors associated with alcohol related self-harm and suicide: New insights and improving evidence based policy and practice Risk factors associated with alcohol related self-harm and suicide: New insights and improving evidence based policy and practice 26 th October 2017 Professor Ella Arensman National Suicide Research Foundation,

More information

A basic approach to a suicidal patient

A basic approach to a suicidal patient A basic approach to a suicidal patient With Dr Joanne Ferguson, Staff Specialist Psychiatry and Addiction Medicine, Royal Prince Alfred Hospital Introduction Talking about suicide is regarded as one of

More information

Chapter 12 1/29/2018. Schizophrenia and Schizophrenia Spectrum Disorders. Epidemiology. Comorbidity. Lifetime prevalence of schizophrenia is 1%

Chapter 12 1/29/2018. Schizophrenia and Schizophrenia Spectrum Disorders. Epidemiology. Comorbidity. Lifetime prevalence of schizophrenia is 1% Chapter 12 Schizophrenia and Schizophrenia Spectrum Disorders Epidemiology Lifetime prevalence of schizophrenia is 1% No difference related to 2 Comorbidity Substance abuse disorders Anxiety, depression,

More information

Mental Health Series for Perinatal Prescribers. Severe postpartum syndromes

Mental Health Series for Perinatal Prescribers. Severe postpartum syndromes Mental Health Series for Perinatal Prescribers Severe postpartum syndromes 2 Maternal Filicides Acutely psychotic - 24% Depression Altruistic - 56% to relieve suffering associated with suicide 80% due

More information

Risk factors for suicidal behaviour in developed and developing nations

Risk factors for suicidal behaviour in developed and developing nations Risk factors for suicidal behaviour in developed and developing nations Stephen Platt University of Edinburgh, Scotland, UK 2 nd Triple-I International Conference Koper, Slovenia, 4-6 May 2011 Outline

More information

Suicidality: Assessment & Management

Suicidality: Assessment & Management Suicidality: Assessment & Management Dr Larkin Feeney Consultant Psychiatrist Cluain Mhuire Community Mental Health Service ICGP Spring Study Sessions IMI 12/04/12 CSO latest suicide statistics 2009 record

More information

Depression Workshop 26 January 2007

Depression Workshop 26 January 2007 Depression Workshop 26 January 2007 Leslie G Walker Professor of Cancer Rehabilitation Donald M Sharp Senior Lecturer in Behavioural Oncology Mary B Walker Senior Clinical and Research Nurse Specialist

More information

Mental Health Referral Form

Mental Health Referral Form Mental Health Referral Form Mailing Address: Niagara Region Mental Health 3550 Schmon Parkway, Second Floor, Unit 2 P.O. Box 1042 Thorold, ON L2V 4T7 905-688-2854 Toll free: 1-888-505-6074 niagararegion.ca/health

More information

Behavioral Emergencies. Lesson Goal. Lesson Objectives 9/10/2012

Behavioral Emergencies. Lesson Goal. Lesson Objectives 9/10/2012 Behavioral Emergencies Lesson Goal Recognize, assess, & treat patients with behavioral emergencies, including patients with psychiatric history & substance abuse Lesson Objectives Define these terms: Suicide

More information

CLIENT HISTORY CLIENT LEGAL NAME: CLIENT PREFERRED NAME:

CLIENT HISTORY CLIENT LEGAL NAME: CLIENT PREFERRED NAME: CLIENT HISTORY CLIENT LEGAL NAME: DATE: CLIENT PREFERRED NAME: FAMILY & SOCIAL BACKGROUND Please list and describe your current family members (immediate, extended, adopted, etc.) and/or other members

More information

Legal 2000 and the Mental Health Crisis in Clark County. Lesley R. Dickson, M.D. Executive Director, Nevada Psychiatric Association

Legal 2000 and the Mental Health Crisis in Clark County. Lesley R. Dickson, M.D. Executive Director, Nevada Psychiatric Association Legal 2000 and the Mental Health Crisis in Clark County Lesley R. Dickson, M.D. Executive Director, Nevada Psychiatric Association Civil action: Civil Commitment Definition a legal action to recover money

More information

CLIENT INFORMATION FORM. Name: Date: Address: Gender: City: State: Zip: Date of Birth: Social Security Number:

CLIENT INFORMATION FORM. Name: Date: Address: Gender: City: State: Zip: Date of Birth: Social Security Number: Name: Address: Gender: City: State: Zip: Date of Birth: Social Security Number: Contact Telephone Numbers Please complete relevant information and indicate the number at which you wish to be contacted

More information

Teen Suicide 2013 Kmcfarlane 10/3/13

Teen Suicide 2013 Kmcfarlane 10/3/13 1 2 3 4 5 6 7 Teen Suicide Kevin McFarlane BSN,RN,CEN,EMT University of New Mexico Hospital Suicide The spectrum of suicide Suicide Defined Suicide: Intentionally causing one s own death. Sometimes difficult

More information

Youth Suicide and Mental Health. Developmental Determinants

Youth Suicide and Mental Health. Developmental Determinants Youth Suicide and Mental Health Developmental Determinants Data Story Presentation Structure: Youth Suicide overview Developmental determinants of risk Mental illness and suicide Prevention Youth Suicide

More information

Adults of Working Age & Older Adults Version

Adults of Working Age & Older Adults Version Revised November 2009 STAR Clinical Risk Assessment Tool DETAILS OF PERSON COMPLETING THE FORM: Adults of Working Age & Older Adults Version Surname: Forename: Team/Service: PATIENT DETAILS Unique ID:

More information

Suicide Prevention in the Older Adult

Suicide Prevention in the Older Adult Suicide Prevention in the Older Adult Nina R. Ferrell, MA Geriatric Outreach Professional Relations Salt Lake Behavioral Health Hospital Presentation Content Credits 1. Addressing Suicidal Thoughts and

More information

CHAPTER 7 SUICIDAL BEHAVIOUR. Highlights

CHAPTER 7 SUICIDAL BEHAVIOUR. Highlights CHAPTER 7 SUICIDAL BEHAVIOUR Highlights In 1998, 3,699 Canadians died as a result of suicide. Suicide accounts for 24% of all deaths among 15-24 year olds and 16% among 25-44 year olds. The mortality rate

More information

Managing presenting alcohol users an Introduction to SPECTRUM (CRI) By Dr Gideon Felton MRCPsych Consultant Psychiatrist and Clinical Lead

Managing presenting alcohol users an Introduction to SPECTRUM (CRI) By Dr Gideon Felton MRCPsych Consultant Psychiatrist and Clinical Lead Managing presenting alcohol users an Introduction to SPECTRUM (CRI) By Dr Gideon Felton MRCPsych Consultant Psychiatrist and Clinical Lead PLAN OF PRESENTATION Assessment of alcohol dependence Psychiatric

More information

SECTION 1. Children and Adolescents with Depressive Disorder: Summary of Findings. from the Literature and Clinical Consultation in Ontario

SECTION 1. Children and Adolescents with Depressive Disorder: Summary of Findings. from the Literature and Clinical Consultation in Ontario SECTION 1 Children and Adolescents with Depressive Disorder: Summary of Findings from the Literature and Clinical Consultation in Ontario Children's Mental Health Ontario Children and Adolescents with

More information

Mental Health - a Public Health Challenge

Mental Health - a Public Health Challenge Mental Health - a Public Health Challenge What is a mental health? Absence of mental illness Positive mental health Mental well-being Public mental health Promotion of mental health Prevention of mental

More information

Deliberate self-harm in Oxford, : a time of change in patient characteristics

Deliberate self-harm in Oxford, : a time of change in patient characteristics Psychological Medicine, 2003, 33, 987 995. f 2003 Cambridge University Press DOI: 10.1017/S0033291703007943 Printed in the United Kingdom Deliberate self-harm in Oxford, 1990 2000: a time of change in

More information

CRISIS COUNSELLING IN PLHIV WITH SUICIDAL IDEATION

CRISIS COUNSELLING IN PLHIV WITH SUICIDAL IDEATION CRISIS COUNSELLING IN PLHIV WITH SUICIDAL IDEATION PRESENTED AT AWACC 2016 DURBAN, SOUTH AFRICA PROFESSOR LOURENS SCHLEBUSCH EMERITUS PROFESSOR BEHAVIOURAL MEDICINE UNIVERSITY OF KWAZULU-NATAL DURBAN SOUTH

More information

Screening for Depression and Suicide

Screening for Depression and Suicide Screening for Depression and Suicide Christa Smith, PsyD Western Interstate Commission for Higher Education Boulder, Colorado 10/2/2008 Background My background A word about language Today stopics Why

More information

December Vulnerable Young People Risk Management Procedure

December Vulnerable Young People Risk Management Procedure December 2011 Vulnerable Young People Risk Management Procedure 1 1.1 1.2 Purpose of this procedure To provide an effective strategy to respond to vulnerable young people who are at risk due to their own

More information

medical attention. Source: DE MHA, 10 / 2005

medical attention. Source: DE MHA, 10 / 2005 Mental Health EMERGENCIES Mental Health: Emergencies This presentation deals with teen suicide, which is a most difficult topic to consider. It is presented upon recommendations from national public and

More information

CRPS and Suicide Prevention

CRPS and Suicide Prevention 1 CRPS and Suicide Prevention Jill Harkavy Friedman, PhD June 23, 2012 RSDSA Board Meeting 2 What we know about suicidal ideation and behavior Majority of people have thought about suicide at some point

More information

SUICIDE IN CHILDREN AND ADOLESCENTS

SUICIDE IN CHILDREN AND ADOLESCENTS SUICIDE IN CHILDREN AND ADOLESCENTS WERNER VAN DER WESTHUIZEN April 2018 Introduction The death of a child is heart breaking for everyone affected, but when a child dies by suicide, it brings a while different

More information

Module: Self-harm/suicide

Module: Self-harm/suicide Module: Self-harm/suicide Overview Learning objectives Promote respect and dignity for people with self-harm/suicide. Know the common presentations of self-harm/suicide. Know the principles of assessment

More information

BROMLEY JOINT STRATEGIC NEEDS ASSESSMENT Substance misuse is the harmful use of substances (such as drugs and alcohol) for non-medical purposes.

BROMLEY JOINT STRATEGIC NEEDS ASSESSMENT Substance misuse is the harmful use of substances (such as drugs and alcohol) for non-medical purposes. 13. Substance Misuse Introduction Substance misuse is the harmful use of substances (such as drugs and alcohol) for non-medical purposes. The term substance misuse often refers to illegal drugs, but, some

More information

CHC08 Community Services Training Package. CHCCS521B Assess and respond to individuals at risk of suicide SAMPLE. Learner guide.

CHC08 Community Services Training Package. CHCCS521B Assess and respond to individuals at risk of suicide SAMPLE. Learner guide. CHC08 Community Services Training Package CHCCS521B Assess and respond to individuals at risk of suicide Learner guide Version 1 INDUSTRY SKILLS UNIT MEADOWBANK Product Code: 5679 CHCCS521ABAssess and

More information

CAMHS: Focus on Self-Harm, Suicidal Ideation in Adolescents. Nov 8 th 2018

CAMHS: Focus on Self-Harm, Suicidal Ideation in Adolescents. Nov 8 th 2018 CAMHS: Focus on Self-Harm, Suicidal Ideation in Adolescents Nov 8 th 2018 Introductions Mel Clarke, Clinical Nurse Specialist, CAMHS Emergency Care Service (CECS) Dr. Gili Orbach, Clinical Psychologist,

More information

The Difficult Patient. Psychiatric Dilemmas in the Primary Care Setting. No Disclosures. Objectives 10/12/17. Erick K. Hung, MD

The Difficult Patient. Psychiatric Dilemmas in the Primary Care Setting. No Disclosures. Objectives 10/12/17. Erick K. Hung, MD Psychiatric Dilemmas in the Primary Care Setting No Disclosures Erick K. Hung, MD Associate Professor of Clinical Psychiatry University of California, San Francisco Objectives Describe approaches to the

More information

Session outline. Introduction to self-harm/suicide. Assessment of self-harm/suicide. Management of self-harm/suicide. Follow-up.

Session outline. Introduction to self-harm/suicide. Assessment of self-harm/suicide. Management of self-harm/suicide. Follow-up. Self-harm/suicide 1 Session outline Introduction to self-harm/suicide. Assessment of self-harm/suicide. Management of self-harm/suicide. Follow-up. Activity 1: Person stories Present the person stories

More information

Creating and Maintaining a Safe and Comfortable Home

Creating and Maintaining a Safe and Comfortable Home Creating and Maintaining a Safe and Comfortable Home Crisis Prevention and Management Training for Limited Mental Health Assisted Living Facility Staff Program Manager and Trainer MARGO FLEISHER Acknowledgements

More information

Humberto Nágera M.D.

Humberto Nágera M.D. The Carter-Jenkins Center presents 1 1 Humberto Nágera M.D. Director, The Carter-Jenkins Center Professor Emeritus of Psychiatry, University of Michigan Professor Emeritus of Psychiatry, University of

More information

JILL L. KOFENDER, PHD, PLLC. Licensed Clinical Psychologist ADULT CLIENT QUESTIONNAIRE. Client s Name Today s Date Gender Age Birthdate

JILL L. KOFENDER, PHD, PLLC. Licensed Clinical Psychologist ADULT CLIENT QUESTIONNAIRE. Client s Name Today s Date Gender Age Birthdate JILL L. KOFENDER, PHD, PLLC Licensed Clinical Psychologist ADULT CLIENT QUESTIONNAIRE Client s Name Today s Date Gender Age Birthdate Cell Phone Is it ok to text? Y N Is it ok to receive appt. reminders?

More information

Assessment and management of selfharm

Assessment and management of selfharm Assessment and management of selfharm procedure Version: 1.1 Consultation Approved by: Medical Director, CAMHS Director, Director of Quality, Patient Experience and Adult services Medical Director Date

More information

MINOR CLIENT HISTORY

MINOR CLIENT HISTORY MINOR CLIENT HISTORY CLIENT NAME: DATE: FAMILY & SOCIAL BACKGROUND: Please list and describe your child s or teen s current family members (immediate, extended, adopted, etc.) NAME RELATIONSHIP AGE OCCUPATION

More information

Adolescent Mental Health. Vicky Ward, MA Sociology Manager of Prevention Services

Adolescent Mental Health. Vicky Ward, MA Sociology Manager of Prevention Services Adolescent Mental Health Vicky Ward, MA Sociology Manager of Prevention Services What is a Mental Disorder? Affects a person s thinking, emotional state and behavior Disrupts the person s ability to Work

More information

SCHIZOPHRENIA AN OVERVIEW

SCHIZOPHRENIA AN OVERVIEW SCHIZOPHRENIA AN OVERVIEW Compiled by Campbell M Gold (2004) CMG Archives http://campbellmgold.com IMPORTANT The health information contained herein is not meant as a substitute for advice from your physician,

More information

Suicidal Behaviors among Youth: Overview of Risk and Promising Intervention Strategies

Suicidal Behaviors among Youth: Overview of Risk and Promising Intervention Strategies Suicidal Behaviors among Youth: Overview of Risk and Promising Intervention Strategies David B. Goldston, Ph.D. Department of Psychiatry & Behavioral Sciences Duke University School of Medicine Goals of

More information

Your patients with mental health problems: Key issues and good practice in the assessment and management of risk.

Your patients with mental health problems: Key issues and good practice in the assessment and management of risk. Your patients with mental health problems: Key issues and good practice in the assessment and management of risk. Why Do People Complete Suicide? Suicide is not a disease, it is complex and multi-factorial.

More information

Mental Health Strategy. Easy Read

Mental Health Strategy. Easy Read Mental Health Strategy Easy Read Mental Health Strategy Easy Read The Scottish Government, Edinburgh 2012 Crown copyright 2012 You may re-use this information (excluding logos and images) free of charge

More information

Lecture Outline. Preventive Mental Health Interventions: School Suicide Intervention. Stephen E. Brock. Ph.D. 1. School Suicide Intervention

Lecture Outline. Preventive Mental Health Interventions: School Suicide Intervention. Stephen E. Brock. Ph.D. 1. School Suicide Intervention Stephen E. Brock, Ph.D., NCSP, LEP California State University, Sacramento Lecture Outline Risk Factors Variables that signal the need to look for warning signs of suicidal thinking. Warning Signs Variables

More information

Suicide/Homicide Precautions OFFICE OF BEHAVIORAL HEALTH

Suicide/Homicide Precautions OFFICE OF BEHAVIORAL HEALTH Suicide/Homicide Precautions OFFICE OF BEHAVIORAL HEALTH Disclaimer Information in this presentation should not be relied upon for diagnosis or treatment of a mental health condition. Resources referenced

More information

Working Together Locally to Address Multiple Exclusion

Working Together Locally to Address Multiple Exclusion Working Together Locally to Address Multiple Exclusion Homeless Link National Conference Workshop 13 th July 2011 Michelle Cornes, Louise Joly (King s College London) and Matthew Bawden (Look Ahead Housing

More information

Assessing Mental Capacity, Mental State Examination and Self Harm. Dr Alison Gray, FRCPsych, Mental Health Liaison Team.

Assessing Mental Capacity, Mental State Examination and Self Harm. Dr Alison Gray, FRCPsych, Mental Health Liaison Team. Assessing Mental Capacity, Mental State Examination and Self Harm. Dr Alison Gray, FRCPsych, Mental Health Liaison Team. Mental Health Liaison Team Internal 5596 07772 901761 01432 354399 Fax 01432 275931

More information

Clinical Risk Assessment and Management

Clinical Risk Assessment and Management Clinical Risk Assessment and Management Practitioners engaged in clinical risk assessment and the development of risk management plans with service users may find the information below a useful guide:

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Psychosis and schizophrenia in children and young people: recognition and management 1.1 Short title Psychosis and schizophrenia

More information

Depressive, Bipolar and Related Disorders

Depressive, Bipolar and Related Disorders Depressive, Bipolar and Related Disorders Robert Kelly, MD Assistant Professor of Psychiatry Weill Cornell Medical College White Plains, New York Lecture available at www.robertkelly.us Financial Conflicts

More information

Depressed Patients: Potential Risk for Suicide. Information for Primary Health Care Professionals

Depressed Patients: Potential Risk for Suicide. Information for Primary Health Care Professionals Depressed Patients: Potential Risk for Suicide Information for Primary Health Care Professionals INTRODUCTION 2 Introduction 3 Suicide an International Dilemma 4 You re in a Unique Position to Intervene

More information

Condensed Clinical Practice Guideline Treatment Of Patients With Schizophrenia

Condensed Clinical Practice Guideline Treatment Of Patients With Schizophrenia Condensed Clinical Practice Guideline Treatment Of Patients With Schizophrenia I. Key Points a. Schizophrenia is a chronic illness affecting all aspects of person s life i. Treatment Planning Goals 1.

More information

CHAPTER 3 SCHIZOPHRENIA. Highlights

CHAPTER 3 SCHIZOPHRENIA. Highlights CHAPTER 3 SCHIZOPHRENIA Highlights Schizophrenia affects 1% of the Canadian population. Onset is usually in early adulthood. Schizophrenia can be treated effectively with a combination of medication, education,

More information

Integrated Primary Care Approach to Suicidal Youth and Adults

Integrated Primary Care Approach to Suicidal Youth and Adults Integrated Primary Care Approach to Suicidal Youth and Adults Bill Elder, PhD Professor of Family and Community Medicine University of Kentucky College of Medicine Source: Dr. Thomas Insel, PowerPoint

More information

Operation S.A.V.E Campus Edition

Operation S.A.V.E Campus Edition Operation S.A.V.E Campus Edition 1 Suicide Prevention Introduction Objectives: By participating in this training you will learn: The scope and importance of suicide prevention The negative impact of myths

More information

Workshop cases answers

Workshop cases answers Workshop cases answers BPSD Workshop: case histories Case 1: Mrs DM Scenario This is an 83 year old lady diagnosed with multi infarct dementia in 2008. Lives with husband and the couple are supported by

More information

Suicide Risk Assessment

Suicide Risk Assessment Suicide Risk Assessment Interviewing Basics Prepared by: Dr. Aviva Rostas Psychiatry Resident, University of Toronto Epidemiology Suicide is common. According to Statistics Canada, in 2009 there were 3,890

More information

Warning Signs of Mental Illness in Children/Adolescents. Beth Confer, MA, LPC Director, Community Relations Clarity Child Guidance Center

Warning Signs of Mental Illness in Children/Adolescents. Beth Confer, MA, LPC Director, Community Relations Clarity Child Guidance Center Warning Signs of Mental Illness in Children/Adolescents Beth Confer, MA, LPC Director, Community Relations Clarity Child Guidance Center Identify At least 5 warning signs of mental illness in children

More information

MINNESOTA National Alliance on Mental Illness. National Alliance on Mental Illness QPR. For Youth. Ask A Question, Save A Life

MINNESOTA National Alliance on Mental Illness. National Alliance on Mental Illness QPR. For Youth. Ask A Question, Save A Life QPR For Youth Ask A Question, Save A Life QPR For Youth Question, Persuade, Refer QPR QPR is intended to offer hope through positive action. QPR is not intended to be a form of counseling or treatment.

More information

Self-harm: Early identification and effective treatments

Self-harm: Early identification and effective treatments Self-harm: Early identification and effective treatments Dr Eve Griffin, National Suicide Research Foundation GROW Information Evening, Understanding and minding your mental health, Tuesday 18 th March

More information

Adult Information Form

Adult Information Form 1 Client Name: Age: DOB: Today s Date Address: City: State: Zip: Home Phone: ( ) Ok to leave message? YES NO Work Phone: ( ) Ok to leave message? YES NO Current Employer (or school if a student): Gender:

More information

DEPRESSION IN CHILDHOOD AND ADOLECENCE

DEPRESSION IN CHILDHOOD AND ADOLECENCE DEPRESSION IN CHILDHOOD AND ADOLECENCE Bob Salo Mood Disorders Childhood Depression Major Depressive Disorder Disruptive Mood Dysregulation Disorder Bipolar Affective Disorder Mainly Depressive Mainly

More information

Inpatient Psychiatry: Are There Opportunities for Documentation Improvement?

Inpatient Psychiatry: Are There Opportunities for Documentation Improvement? 7th Annual Association for Clinical Documentation Improvement Specialists Conference Inpatient Psychiatry: Are There Opportunities for Documentation Improvement? Teresa Hegard, RN, BSN, CCDS Mayo Clinic

More information

Depression among Older Adults. Prevalence & Intervention Strategies

Depression among Older Adults. Prevalence & Intervention Strategies Depression among Older Adults Prevalence & Intervention Strategies Definition Depression is a complex syndrome complex characterized by mood disturbance plus variety of cognitive, psychological, and vegetative

More information

Suicide Prevention and Intervention

Suicide Prevention and Intervention Suicide Prevention and Intervention Kim Myers, MSW May 2, 2017 Division of Substance Abuse and Mental Health Overview Suicide in Utah Suicide Risk & Protective Factors Suicide Warning Signs C-SSRS Safety

More information

*Please complete this form and bring to your first appointment. This information is fundamental to the assessment and treatment process.

*Please complete this form and bring to your first appointment. This information is fundamental to the assessment and treatment process. *Please complete this form and bring to your first appointment. This information is fundamental to the assessment and treatment process. PATIENT CONTACT INFORMATION Name Age Date of birth Phone ( ) Mailing

More information

Real Men Real Depression

Real Men Real Depression Real Men Real Depression Cheryl A. Clark, MD Distinguished Fellow, American Psychiatric Association Diplomate, American Board of Psychiatry and Neurology Medical Director Clinical Director Mental Health

More information