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SPAN-CA Workshop on Suicide Prevention
Presented at NAMI California Annual Conference, Aug 2004
This issue is of special importance to those living with mental illness and their family members and friends, since mental illness (especially mood disorders) is a major factor contributing to suicide. Over 90% of people who commit suicide have a mental disorder. As Sam Bloom (SPAN-CA member) said, "suicide is the worst outcome of a mental illness."
Special risks for the mentally ill that can increase suicidal behavior include:
Although people commonly believe that schizophrenia patients are at highest risk for suicide during a psychotic episode, they are actually at higher risk after a long recovery spell. This is when depression and hopelessness about living life with a brain disease can take their toll.
The good news is that the vast majority of people (up to 75%) seriously contemplating suicide display warning signs, and if we can recognize these signs, it is more than likely that we can prevent a tragedy.
Some of the signs to watch for include:
What can you do if a friend or family member is displaying these signs?
First of all, don't be afraid to directly ask them if they are contemplating suicide. A suicidal person will probably not bring it up, so it's up to concerned loved ones to directly address the issue if they are concerned. The next thing to do is apply the CPR acronym - Current plan, Prior Attempts, and Resources
Asking about a current plan - do you know how you're going to kill yourself? Do you have the weapon? Do you have a date, a time, and a place? - is painful and frightening, but necessary because it helps you assess the immediate risk to your loved one. By being direct and open, you are also sending a message that it's okay to talk to you. You have to be able to talk about suicide before you can help a suicidal person.
You can assess risk by asking the suicidal person four questions:
The risk of suicide can be broken down based on whether the person has a current plan, has the means to kill themselves, and has had a prior suicide history. Once you have a feel for the risk and the immediacy of the plan, you can contact the best resources to get help.
Everyone who has suicidal thoughts needs consistent follow-up. Call and check in, or ask them to call you at a particular time so you know they are okay. If they refuse to or fail to check in, you know you must take immediate action. Re-negotiate a no self-harm contract if necessary, and focus on getting the person adequate treatment.
For more information and resources, or to find
a 24 hour crisis center near you, go to http://www.suicidology.org,
Key things to remember: