Source [[Book - An Atlas of Depression]] **Signs of suicidal risks** - act of deliberate self-harm planned long in advance - suicide note written; - acts taken in anticipation of death (e.g. writing a will); - being alone at the time of deliberate self-harm; - patient making attempts to avoid discovery; - not seeking help after deliberate self-harm; - stating a wish to die; - believing the act of deliberate self-harm would prove fatal; - being sorry the act of deliberate self-harm failed; and - continuing suicidal intent. People with [[Depression]] have higher risk for deliberate self-harm and suicide **Risk Factors for Suicide (source [[Book - An Atlas of Depression]]) - older age; - male gender; - single status; - personality disorder; - history of aggression; - suicidal thoughts; - social isolation; - physical illness; - alcohol abuse; and - recent suicide attempt. - Recent loss of spouse or parent - KaprioJ,KoskenvuoM,RitaH.Mortalityafterbereavement: a prospective study of 95,647 widowed persons. Am J Public Health 1987;77:283–7 - Bunch J. Recent bereavement in relation to suicide. J Psychosom Res 1972;16:361–6) --- # Suicide Risk Factors ^b240f3 From [[Book - Psychotherapy and Counselling for Depression 3rd Ed]] A series of risk factors should be kept in mind when assessing depression and its associated difficulties (Hawton, 1987; MacLeod, 2004). The factors that may increase the risk of a suicide attempt are: - personality disorder, especially with poor impulse control - use of alcohol to escape problems - being young, male and unemployed - a history of previous self-harm - living alone and social isolation - major life events of losses and exits - illnesses that involve reduced capacities and/or chronic pain - family disputes and high expressed emotion - anniversaries of losses - sudden separations (e.g. from a keyworker) - a suicide in the family. ---- News: - **In 2022, Singapore recorded 476 suicide cases, the highest since 2000 when there were 348 cases** - **The Samaritans of Singapore's** **figures showed that the highest number of deaths in 2022 was among people aged 20 to 29 and the highest increase was among seniors aged 70 to 79** - **Suicide remains the leading cause of death for the fourth consecutive year among people aged 10 to 29** - **The most frequently presented problems for those who seek help with SOS involved family, jobs finances and romantic relationships** - **SOS said suicide prevention is a complex issue involving various stakeholders and everyone needs to “continue to turn conversations into actions”** - [Singapore sees highest number of suicides in over 20 years, with most cases among those in their 20s: SOS - TODAY (todayonline.com)](https://www.todayonline.com/singapore/singapore-suicide-death-sos-2202996 - [[Interview with Mr Phua Chun Yat, SOS Chief Operating Officer by CNA]] - [[Attended a presentation reviewing past Suicide Cases]] # Causes, Reasons? ## Depression ## Violence ==Victims of teen dating violence are more likely to do poorly in school, show earlier sexual debut, and engage in binge drinking, suicide attempts, and physical fighting. Victims may also carry the patterns of violence into future relationships (CDC, 2010; Silverman, Raj, Mucci, & Hathaway, 2001). Page 68-69)== - source [[202011030838 Book Notes of Bullying Scars]] ## Sense of Self - Shame and Guilt sometimes incite suicidal thought and actions, there are two major sources of shame and guilt [slide 47], "_Shame bring about effects of wanting to hide, and extreme shame can bring forth suicide_.” - Source [[202008191814 How to reduce Shame and Guilt]] ## "I am not worth it", "I am taking up space", **"I don't deserve to live"** ## "There is no hope for me" ## Existential - "There is no meaning" ## Isolation, Loneliness - [[The anticipation of being alone was associated with an increase of suicide]] # What can be done? - [[202009101947 Reading notes Asking useful questions. Suicide]]