SUICIDE

BY
MR SIMBEYE T.S
 INTRODUCTION
• Suicide is a tragic and potentially preventable
public health problem (Vorvick, 2011).
• The factors that contribute to any particular
suicide are diverse and complex.
• Therefore, efforts to understand it must
incorporate many approaches (Vorvick, 2011).
INTRODUCTION CONT’D

• Suicidal behaviour encompasses suicide

gestures, suicide attempts, and
completed suicide.
• Some people attempt suicide in a way
that is somewhat non-violent, such as
poisoning or overdose.
• Females are less likely to choose violent
methods, such as shooting themselves.
 INTRODUCTION CONT’D
• Relatives of people who attempt or
commit suicide often blame themselves
or become very angry.
• However, people who try to commit
suicide often mistakenly believe that
they are doing their friends and relatives
a favour by taking themselves out of the
world.
 INTRODUCTION CONT’D
• People who try to commit suicide are often
trying to get away from a life situation that
seems impossible to deal with.
• Many who make a suicide attempt are
seeking relief from: Feeling ashamed, guilty,
a burden to others, feeling like a victim and
feelings of rejection, loss, or loneliness
 Definition of terms

• Suicidal behaviour - is any action that could cause a

person to die, such as taking a drug overdose or
crashing a car on purpose (Vorvick, 2011).
• Suicide gesture – suicidal plans and actions that
appear unlikely to be fatal (Berkow, R. et al 1999).
 Definition of terms
• Suicide attempts – suicide actions that are intended
to be fatal but that don’t succeed (Berkow, R. et al
1999).
• Complete suicide - suicide action that results in
death (Berkow, R. et al 1999).
 Definition of SUICIDE
• Suicide is a process of purposely ending one’s own
life.
• Suicide is the act of taking one's own life on
purpose (Vorvick, 2011).
There are four types of suicides and these are:
• Egoistic suicide
• Anomic suicide
• Altruistic suicide
• Fatalistic suicide
 TYPES OF SUICIDES
• EGOISTIC SUICIDE: This type of suicide is a result of
excessive "individuation", or isolation from the
social group as a whole.
• A lack of social integration will lead an individual to
possibly take his/her life as a last ditch resort from
depression and isolation.
 TYPES OF SUICIDES
• Durkheim found out that males, usually the single
ones, were much more likely to commit suicide
than those with better social connections (i.e.
customs, jobs, families).
• Males are more likely, as well, to seek out an
individual life away from a community, which can
lead to depression and kill himself.
 TYPES OF SUICIDES
• ALTRUISTIC SUICIDE: Altruistic suicides are from
high integration of society.
• This is the opposite of Egoistic suicide.
• These people will die for the common good, as their
personal needs do not seem important compared
to the group as a whole.
• An example in the military service, a soldier is
expected to die for his/her country.
 TYPES OF SUICIDES
• FATALISTIC SUICIDE: Fatalistic suicides are due to
excessive social restraint.
• Example, a man who kills himself before the police
take him to jail because he views a jail more
oppressive which can prevent the man from
fulfilling his dreams.
• This occurs in conservative countries or strict,
traditional societies.
 FOUR TYPES OF SUICIDES
• ANOMIC SUICIDE: Anomic suicides are the result of
a lack of meaning with one's life.
• In other words, no moral regulation makes it
impossible for a man to establish his/her own place
in the universe.
• A meaningless world would leave a man confused,
lead a life of mystery, and the value of his/her own
life becomes worthless.
 WHY PEOPLE KILL THEMSELVES
• Depression
• Psychosis
• Impulsive ideas:
• Crying out for help:
• Philosophical desire to die
• Disappointment:
 CAUSES
• Suicidal behaviour usually results from
several factors:
• Mental disorders – primarily depression,
Bipolar disorder, Borderline personality
disorder, and substance abuse.
• Social factors – Depression due to an
unplanned pregnancy and post-traumatic
disorders (PTD) such as disappointment, loss
of a loved one, and a lack of social support
during difficult situations.
 CAUSES CONT”D
• Overwhelming situations or events –an
incurable physical illness such as being
HIV positive, Cancer of the cervix and
breast and aging.
• Personality – impulsiveness and
aggression.
 RISK FACTORS
• The risk factors for suicide are associated
with changes in brain chemicals called
neurotransmitters, including serotonin.
 RISK FACTORS CONT’D

• Decreased levels of serotonin have been

found in people with depression,
impulsive disorders, and a history of
suicide attempts, and in the brains of
suicide victims (Callanan & Davis, 2011)
 RISK FACTORS CONT’D
• Demographic factors – Male, increasing age,
low socioeconomic status, unmarried,
separated, widowed, living alone and
unemployed.
• Background history - Deliberate self-
harm ,Childhood adversity (e.g. sexual abuse),
family history of suicide and family history of
mental illness.
 RISK FACTORS CONT’D
• Clinical history - Mental illness diagnosis,
personality disorder diagnosis, Physical
illness, especially chronic conditions and/or
those associated with pain and functional
impairment (e.g. multiple sclerosis,
malignancy, pain syndromes)
 RISK FACTORS CONT’D
• Psychological and psychosocial factors -
Hopelessness, impulsiveness, low self-
esteem, relationship instability and lack
of social support
• Current ‘context’ - Suicidal ideation,
suicide plans and availability of means
(e.g. access to guns).
 METHODS
• The method a person chooses for committing
suicide is determined by availability, cultural
factors and seriousness of intent.
• Drug overdose (poisoning) is the most
frequently used method in suicide attempts.
• It is nonviolent.
• With this method, rescue is possible.
• This method is commonly used by women.
 METHODS CONT’D
• Suffocation/hanging using a rope
• Drowning which is nonviolent method. This is
common in the village set-up.
• Jumping from a tall building, this method
makes survival virtually impossible.
• Firearms- very few women uses firearms, and
if used, they avoid shooting the face for
cosmetic purposes in case they do not die.
 METHODS CONT’D

• Firearms are the method most frequently

used in complete suicide. It is mostly used
by men and boys. It is avoided by those
attempting suicide because it results to
death (Callanan & Davis, 2011)
 SYMPTOMS
• Having trouble in concentrating or
thinking clearly.
• Giving away belongings.
• Talking about going away or the need to
"get my affairs in order".
 SYMPTOMS CONT’D
• Suddenly changing behaviour, especially
calmness after a period of anxiety.
• Loss of interest in the activities that they
previously used to enjoy.
• Performing self-destructive behaviours, such
as heavy alcohol consumption, using illegal
drugs, or cutting their body.
 SYMPTOMS CONT’D
• Pulling away from friends or not wanting
to go out.
• Suddenly having trouble in school or
work.
• Talking about death or suicide.
• Talking about feeling hopeless or guilty.
• Changing sleep or eating habits.
 TREATMENT
Many people who attempt suicide are
admitted to hospital. When a person who has
taken an overdose of a drug or poison is
known, the following steps can be taken;
• Remove as much of the drug or poison from
the person’s body to prevent its absorption
and speed its excretion.
• Depending on the substance ingested, gastric
lavage can be done or intravenous infusion
can be administered.
 TREATMENT CONT’D
• Monitor vital signs and treat the symptoms
to keep the person alive.
• Administer an antidote if the specific drug
ingested is known and if an antidote exists.
• Although most people are physically well
enough to be discharged as soon as an
injury is treated, they are often
hospitalised for psychiatric assessment and
treatment.
ASSESSMENT OF PATIENT FOLLOWING
ATTEMPTED SUICIDE
• When assessing a patient who has harmed
herself or expressed ideas of doing so, a
systematic approach is essential.
• Assess:
1. Current attempt
• How do they explain the attempt?
• What was the degree of suicide intent?
• Is there evidence of psychiatric illness?
 BACKGROUND
• Have they made previous suicide attempt?
• Take family and personal history.
• Provide the patient with social support
• Counsel the Patient on how to cope with
stress
 IMPACT OF SUICIDE

• A successful suicide has a powerful

emotional impact on anyone affected.
The person’s family, friends, and doctors
may feel guilt, shame and remorse at
having failed to prevent the suicide.
IMPACT OF SUICIDE CONT’D
• They may also feel angry toward the
person.
• Eventually they realise that they could
not be all –knowing and that the suicide
in most cases could not have been
prevented (Haslett, 2002).
 CONCLUSION

• Suicidal behaviour encompasses suicidal

gesture, suicidal attempts and successful
suicide. Some people attempt suicide in
a way that is non-violent such as
poisoning or drug overdose, while some
attempt or commit suicide using violence
such as the use of firearms. Many people
who try to commit suicide talk about it
before making the attempt.
 CONCLUSION CONT’D
• Sometimes, just talking to someone who
cares and who does not judge them is
enough to reduce the risk of suicide.
Never ignore a suicide threat or
attempted suicides instead carry out a
psychiatric assessment. Advising people
at risk to avoid alcohol and keeping drugs
(other than prescribed medicines) can
help reduce the risk of suicide.
 REFERENCES
• Berkow, R. et al, (1997), The Merck Manual
of Medical Information, 7th edition, Merck
Research Laboratories, New Jersey.
• Haslett, C. Et al, (2002), Principle and
practice of medicine, 19th Edition. Churchill
Livingstone, Philadelphia.
 REFERENCES

• BMJ-British Medical Journal, (2008),

Antidepressants Accounts For Only 10% Of
Fall in Suicide Rates Among Older People.
Available at
[Link]
4/[Link]. Retrieved on 02/03/12

• Callanan V.J & Davis M. S, (2011), Gender and

Suicide Method: Do Women Avoid Facial