An exploration of nurses' attitudes to the nursing care of the suicidal patient in an acute psychiatric ward
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Abstract:
Suicidal patients admitted to hospital following a suicidal attempt or expressing suicidal ideation present a real challenge to health professionals with regard to their therapeutic care. This study was undertaken to explore the attitudes of psychiatric nurses caring for such patients. Results reveal that psychiatric nurses do hold positive views on caring for potentially suicidal patients, contradicting previous studies where more negative feeling were expressed by nurses, especially those with initial contact. Findings also show that some nurses experience an element of distress, and the length of experience within such a working environment does not affect the nurses' level of satisfaction gained on caring for the suicidal patient. This study also identifies an expression of need for further education and practice in interpersonal skills and therapeutic modalities to enhance and develop a more effective delivery of care for this group of patients.Keywords:
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Outpatient clinic
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Hotline callers do not always have suicidal ideation and previous studies have noted that the rate of such callers is limited. Crisis hotline counselors must be able to identify high‐risk callers in order to provide appropriate support. This study investigated the characteristics of Japanese crisis hotline callers in 2012 ( N = 541,694) and is the first to analyze crisis hotline data for all parts of Japan over 1 year. About 14% of the callers had suicidal ideation and 6% had a history of attempted suicide. The odds ratio for suicidal ideation among those with a history of attempted suicide was 15.5. The suicidal ideation rate was much smaller compared to previous studies in other countries. There is a psychological barrier that must be broken for high‐risk people to use support hotlines. In addition, attempted suicide is a strong exclusive predisposing factor for death due to suicide; therefore, counselors should pay careful attention to callers with a history of attempted suicide. The characteristics of Japanese crisis hotline callers and the features of suicidal ideation revealed in the present study are expected to be useful in developing telephone crisis hotline strategies.
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Approximately half of those who attempt suicide report experiencing suicidal ideation and suicidal planning in advance; others deny these experiences. Some researchers have hypothesized that rapid intensification is due to past suicidal ideation and/or behaviors that are "mentally shelved" but remain available for rapid access later.To evaluate this hypothesis, we examined (a) temporal sequencing of suicidal ideation, suicidal planning, and suicidal behavior, and (b) speed of emergence of suicidal behavior in a prospective cohort study of 2744 primary care patients.Of 52 patients reporting suicidal behavior during follow-up, 20 (38.5%) reported suicidal ideation and planning prior to their suicidal behavior, 23 (44.2%) reported suicidal ideation but not planning, and nine (17.3%) denied both suicidal ideation and planning. Over half (n = 30, 57.7%) reported the onset of suicidal ideation and/or planning on the same day as or after their suicidal behavior (i.e., rapid intensification). Rapid intensification was not associated with increased likelihood of reporting recent or past suicidal ideation, planning, or behaviors, suggesting rapid intensification does not depend on prior experience with suicidal ideation and/or behaviors.Detecting primary care patients at risk for this form of suicidal behavior may be limited even with universal suicide risk screening.
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Suicidal Behavior
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Suicidal ideation during adolescence is quite common. Longitudinal ideation patterns may predict adolescents at greatest risk of progressing to more serious suicidal behaviors. We enumerated suicidal ideation trajectory subgroups and estimated subgroup association with later suicidal plans and attempts using data collected across a 13‐year period from 552 Caucasian adolescents. Three subgroups were found: non‐ideators (no ideation), decreasers (ideation decreased), and increasers (ideation persisted or increased). Probability of planning a suicide was greatest among increasers (females: .54, males: 51, p < .01). Probability of attempting suicide was greatest among male decreasers (.36, p < .01) and female increasers (.25, p < .01).
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Purpose Being bullied is associated with the manifestation of suicidal feelings, which sharply increase in middle(-late) adolescence. Whether or not bullied middle(-late) adolescents with suicidal feelings seek help is therefore a critical issue, given that help-seeking plays a key role in the prevention of suicide. The aim of the present study is to investigate the effects of bullying, suicidal feelings and the interaction between these two factors on help-seeking behavior in adolescents. Methods Japanese middle(-late) adolescents (aged 15–18 years; n = 9484) were studied using self-report questionnaires. The rate of adolescents who actually sought help was examined for bullying status and suicidal feelings. Results The rate of adolescents who sought help was significantly higher when they were bullied (p<0.001) and also when they had mild suicidal feelings (p<0.001), but not when they displayed serious suicidal feelings. In the case of adolescents who were bullied, however, having suicidal feelings significantly decreased the rate of help-seeking (OR = 0.47, p<0.05 and OR = 0.32, p = 0.002 for having mild and serious suicidal feelings, respectively). The decrease was remarkable when suicidal feelings were serious. Specifically, the decrease was significant in seeking help from peers and family members, who are the most frequent source of the help for adolescents, when they had serious suicidal feelings (OR = 0.21, p<0.01 and OR = 0.13, p<0.001, respectively). Conclusions Suicidal feelings may interfere with help-seeking behavior, which could be critical in suicide prevention in bullied middle(-late) adolescents.
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The purpose of this study was to determine whether suicidal ideation and/or suicide attempts have any long‐term health effects. The relationship between suicidal thoughts and/or a previous suicide attempt in 1994 and the presence of suicidal ideation in 2000 was analyzed. We found that health status in 1994 differed significantly between the groups with and without suicidal ideation or a previous suicide attempt and that the differences persisted or even deepened (not significant) after 6 years. Further, people who had suicidal ideation or a suicide attempt in 1994 had a significantly greater risk (OR = 7.4) of having suicidal ideation in 2000 than people who had not.
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Suicidal Behavior
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Suicidal thoughts and behaviors among youths are important public health concerns in Utah, where the suicide rate among youths consistently exceeds the national rate and has been increasing for nearly a decade (1). In March 2017, CDC was invited to assist the Utah Department of Health (UDOH) with an investigation to characterize the epidemiology of fatal and nonfatal suicidal behaviors and identify risk and protective factors associated with these behaviors, among youths aged 10-17 years. This report presents findings related to nonfatal suicidal behaviors among Utah youths. To examine the prevalence of suicidal ideation and attempts among Utah youths and evaluate risk and protective factors, data from the 2015 Utah Prevention Needs Assessment survey were analyzed. Among 27,329 respondents in grades 8, 10, and 12, 19.6% reported suicidal ideation and 8.2% reported suicide attempts in the preceding 12 months. Significant risk factors for suicidal ideation and attempts included being bullied, illegal substance or tobacco use in the previous month, and psychological distress. A significant protective factor for suicidal ideation and attempts was a supportive family environment. UDOH, local health departments, and other stakeholders are using these findings to develop tailored suicide prevention strategies that address multiple risk and protective factors for suicidal ideation and attempts. Resources such as CDC's Preventing Suicide: A Technical Package of Policy, Programs, and Practices (2) can help states and communities identify strategies and approaches using the best available evidence to prevent suicide, which include tailored strategies for youths.
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ABSTRACT : A total of 737 university students were surveyed using a psychometrically sound self‐report measure of suicidal ideation. Over 43% of those participating were found to have experienced some level of suicidal ideation during the previous year. Of those found to have had suicidal thoughts, 14.9% in some way acted on those thoughts without actually making suicide attempts. An additional 5.5% were found to have made attempts on their lives. Serious suicidal ideation and actual attempts were related to several demographic traits, and implications of the results are discussed. In general, findings indicate that the problem of youth suicide may involve a greater percentage of young people than previously thought. Moreover, findings provide indirect support for the hypothesis that the difference in male‐female completed suicide rates is primarily a function of the lethality of the attempts.
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Suicide ideation
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Completed suicides reflect only a portion of the impact of suicidal behavior; sublethal behaviors cause morbidity and can signal treatable problems such as depression. There is no national quantification of nonlethal suicidal behaviors. The present study used a random‐digit‐dialed telephone survey to estimate the 12‐month incidence of suicidal ideation, planning, and attempts among U.S. adults. Of 5,238 respondents, 5.6% (representing about 10.5 million persons) reported suicidal ideation, 2.7% (about 2.7 million) made a specific suicide plan, and 0.7% (about 700,000) made a suicide attempt (estimate = 1.1 million attempts). Hence, suicidal behaviors are not uncommon and occur along a continuum ranging from ideation to completed suicides. Preventing nonlethal precursor behaviors may prevent deaths.
Suicidal Behavior
Depression
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Telephone survey
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The purpose of the current study was to examine the possibility that there are multiple pathways to suicidal behavior by conducting a fine-grained investigation of the relationship between suicidal thought content and suicidal behavior.Six thousand two hundred US adults completed self-report measures of suicidal thoughts and behaviors. Descriptive statistics and logistic regression were used to examine the relationship between suicidal thoughts and behaviors.About 36.0% of participants with a lifetime suicide attempt denied ever experiencing any active suicidal thoughts and 11.0% denied ever experiencing any suicidal thoughts; 53.8% of recent attempters denied recent active suicidal thoughts and 22.6% denied any recent suicidal thoughts. Additionally, the sole presence of passive suicidal ideation was associated with increased odds of lifetime and past-month suicide attempts.These findings suggest that there are likely multiple pathways to suicide, some of which do not involve progressively worsening suicidal thoughts.
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Odds
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