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Risk Assessments

From ANCC Review

Suicide risk factors divorced, single, separated, youth (15-24) >45 yo M, >55 yo F; elderly >65, white, M, lives alone, physical illness, Mood d/os (80% schiz., 10% dementia, 5% delirium), substance use, family hx of suicide, previous attempt, recent loss, various occupations
Occupations associated with suicide risk factors law enforcement, dentists, artists, mechanics, lawyers, insurance agents, physicians
Life stressor risk factors for suicide early loss/separation from parents, death of partner, loss of job/income, sudden fall of SES, LGBTQI, recent childbirth, sexual abuse, prior attempts or copycat, hallucinations, delusions, severe psych or chronic physical illness, severe family pathology
Copycat suicides are more common in children
Suicide PROTECTIVE Factors married, employed, stable family/work rxnshps, health, low substance use/social drinker, optimism, achievement (school/work/community), 1st suicide attempt, low lethality method w/ rescue inevitable, primary wish for change/good insight, social support
When assessing someone for suicide, one should look at both risk and protective factors
When assessing suicidal thoughts look at suicidal ideas or fantasizing
When assessing a suicide plan consider lethality of method
These are associated with high lethality guns, hanging, jumping, drowning, high ASA/tylenol overdose, carbon monoxide, car crash. Tricyclic and trazadone too
Speaking of trazadone, it is from what class? Serotonin Antagonist & Reuptake Inhibitor (SARI)
Indicators for inpatient treatment for suicidal patient history of impulsive behavior, suicidal plan with intent to act, absence of strong support system.
During inpatient treatment, it is important to determine the need for close observation vs. constant observation
Close observation is q15 min checks
Constant observation is 1:1 arms length
This should always be considered the least restrictive environment 24-72 hour crisis stabilization in community respite care Patient Aligned Care Team (PACT)
According to the reviewer, this is the strongest predictor of suicide hopelessness, but through my own google search, previous attempts and severity of depression were cited as well.
Homicide Risk Factors past hx of threats/acts of violence, direct threats to others, substance use/tx noncomp., young, male, low SES, culture of violence, access to weapons, psychotic symptoms, manic symptoms, hx of head injury/epilepsy/neuro impairment, hx of psych dx
Psych hx associated with homicide risk factors impulsive, explosive, suspicous, persecutory manner
Intimate Partner Violence - victim is at highest risk when leaving abuser
the number of female victims killed by an intimate 1/3, 3% male murder victims by intimate. Female rate dropped and rose and male rate dropped.
Risk factors for intimate partner violence homicide abuser threats use of weapon, prior attempts, hx of jealousy, rape, increase in violence, illicit drug use, violence outside home, beating while pregnant, prior reports of child abuse, killed/harmed pet, recently discussed separation, victim belief
Created by: jonquil