Over 90 percent of the people who die by suicide have a mental illness at the time of their death. Examples of the mental illnesses include depression, schizophrenia, and bipolar disorder. Unfortunately, most of these mental illnesses are undiagnosed. Untreated depression is the number one mental illness associated with suicide. Also, people with genetic disposition to depression may manifest no signs or symptoms of depression, but may still commit suicide. The question, tragically, is why were these illnesses undiagnosed? Where were the comprehensive health assessments? We are taught our first semester in nursing school to always obtain a comprehensive assessment at the client’s initial visit. This includes a family history, personal history, and social history. The family history section identifies illnesses of genetic, familial, or environmental nature that may affect the client’s current or future health. History of mental illness is one of the questions in this assessment. The personal history section asks the client for a general statement of feelings about themselves, and the family and social section asks about general satisfaction with interpersonal relationships, including significant others, other people in the house hold, etc. Questions are asked about diet and nutrition and changes in eating habits. Mental health questions are asked to assess stress, depression, irritability, etc. As an adult, I have no recollection of ever answering questions of these types for any doctor/clinic/medical facility I have visited. If a comprehensive health history had been correctly administered to the over 90 percent, would they have remained alive? We as healthcare providers need to remember that the information we are taught in classroom settings is not intended for regurgitation on an exam. It is designed to be a tool in increasing the wellness of our clients – even to the point of saving their lives.
Original Post
July 14, 2009
Title: Suicide, comment
Suicide is known to be associated with mental disorder. It may be in form of major depression or some sudden trigger which causes an individual to act irrationally. The ideation of suicide can be very subtle especially when nurses do not detect the signs. some patients are very crafty and may disguise very professionally as well. So the duty is on the nurses to pry deeply on the patients when assessing life stressors which may likely make patients to contemplate suicide. Often, known patients with mental illnesses are protected by HIPPA except cases that are already committed to psychiatric settings. For adolescents, they often display their emotions which helps nurses to quickly act on the information observed or stated but when it becomes a case of prolonged ideation for which the patient has had a means and time to do the act then nurses must still be vigilant. One cannot overemphasis the pivotal importance of detailed assessment and constant reevaluation of any event or attitude which may suggest that a patient is in danger of committing suicide. Once at a psychiatric hospital, a room mate committed suicide suddenly. Nurses were surprised because the patient most have acted within the spur of the moment while disguising the traits associated with suicide ideation. Quality and risk analysis in hospital settings are still open to these investigations. Nurses can also use support groups as well.
Original Post:
June 5, 2009
Title: Suicide
Suicidal ideation is more common than completed suicide. Most persons who commit suicide have a psychiatric disorder at the time of death. Because many clients with psychiatric disorders are seen by family physicians and other primary care practitioners rather than by psychiatrists, it is important that these practitioners recognize the signs and symptoms of the psychiatric disorders (particularly alcohol abuse and major depression) that are associated with suicide. Although most patients with suicidal ideation do not ultimately commit suicide, the extent of suicidal ideation must be determined, including the presence of a suicide plan and the patient’s means to commit suicide.
Many clients who commit suicide have seen their primary care physician within several months before their death and many of these physicians were unaware of the clients’ intentions or that the clients had previously attempted suicide.
The best way to prevent suicide is to ask clients with symptoms of these disorders more specific questions about recent stressors and their thoughts about suicide, excellent history taking is essential to help diagnose clients with suicidal ideation. Reviewing the clients medical history for chronic illness, obtain a drug history and ask the client about family…listen for clues!
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