Suicide_Risk_Assessment in hospital.pptx

Suicide risk assessment

1. Suicide Risk Management In Hospital Prepared By : Dr. Mohamad Asyraf Supervised by Dr Ling Shao Ling

2. INTRODUCTION Primary prevention is about to identify potential risks of suicide and to manage them accordingly Potential risks of suicide includes: Risk factors – conditions/situations associated with high suicide risk; emotional and behavioural changes; suicidal behaviour

3. WHAT IS SUICIDE & INPATIENT SUICIDE? Based on Incident Reporting statistics, there were 50 reported cases of inpatient suicide in MOH hospitals from the year 2012 to 2014. Suicide – “Self inflicted death with evidence (explicit or implicit) that the person intended to die Inpatient suicide -“suicide committed by medically ill patient who is hospitalized within the hospital premises”. Although it is relatively rare, inpatient suicide is a traumatic event for patients’next of kin, for staff Indication of a ‘system failure’ in our healthcare as patient should be safe when they are under our care. 40 reported cases of inpatient suicide in MOH hospitals 2012 – 2014 (Based on the MOH Hospital Incident Reporting statistics) 3

4. 4 DEFINITION OF SUICIDE Sept 2015 Suicide Risk Management_nha

5. EPIDEMIOLOGY 5 Suicide worldwide in 2019: Global Health Estimates © World Health Organization 2021

6. Epidemiology 6 Suicide worldwide in 2019: Global Health Estimates © World Health Organization 2021

7. RISK FACTORS Absent of risk factors but display warning signs Suicide prevention begins with an awareness of the WARNING SIGNS of suicidal behaviour Take any suicidal talk or behaviour SERIOUSLY …… it’s a CRY FOR HELP

8. WARNING SIGNS Conditions associated with increased risk of suicide Emotional and behavioural changes associated with suicide Suicidal behaviour

9. CONDITIONS ASSOCIATED WITH INCREASED RISK OF SUICIDE Death or terminal illness of relative or friend Divorce, separation, broken relationship, stress on family Loss of health Loss of job, home, money, status, self-esteem, personal security Alcohol or drug abuse Psychiatric diagnosis esp Depression Family history of psychiatric diagnosis or suicide Physical health problems (medical illness) Traumatic brain injury Delirium or dementia Chronic pain / intense, unbearable pain Poor prognosis Social stressor – financial constraints, unemployment, relational issues Disability

10. EMOTIONAL & BEHAVIOURAL CHANGES ASSOCIATED WITH SUICIDE RISK Irritability Increased anxiety, Agitation Impulsivity Suicidal ideation and suicidal behaviour Decrease emotional reactivity Complaining of unrelenting pain Refusal to see visitors; social isolation Refusing to eat Refusing medications Requesting early discharge Meeting the diagnostic criteria form depression Feelings of hopelessness, worthlessness, shame, guilt Decreased interest in treatment and prognosis

11. VERBAL, NON-VERBAL, AND TACTILE INDICATORS Cummings Graduate Institute for Behavioral Health Studies

12. VERBAL WARNING SIGNS “ I wish I could disappear forever” “ I want to run away” “ Nobody cares, I may as well be dead” “I want to go to sleep and not wake up” “I hate my life” “I just can’t take it anymore”

13. TACTILE INDICATORS Cummings Graduate Institute for Behavioral Health Studies

14. HOW TO APPROACH 17

15. PROTECTIVE FACTORS Protective Factors: those that can be enhanced to reduce risk

16. THANK YOU 