M.Sc NURSING final year topic for psychiatrics nursing

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3. INTRODUCTION
Self destructive behavior include
 Direct: any form of suicidal activity, such as
suicide ideation, threats, attempts and completed
suicide. The intent of this behavior is death and the
person is aware of the desired behavior.
 Indirect : any activity that is harmful to person’s
wellbeing and potentially may result in death. The
person may be unaware of this potential and may
deny it if conforted
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4. EPIDEMIOLOGY OF SUICIDE
According to the WHO 2020 estimates, 8 lakh
people globally die by suicide every year which
amounts to a suicide death every 40 s. Suicide
attempts are thought to be at least 25 times the
suicide death rates.
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5. SUICIDAL BEHAVIOUR
 Suicidal gestures
 Suicide threats
 Suicide attempts
 Completed suicide
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6. Suicidal gestures
It is a suicide attempt directed towards the goal
of receiving attention rather than actual destruction
of the self
 Suicide threat It may be veiled but usually
occurs before overt suicidal activity takes place
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7. SUICIDE ATTEMPT
 Any self directed actions taken by the individual
that will lead to death if not interrupted
COMPLETED SUICIDE
 It is the death from self inflicted injury, poisoning or
suffocation where there is evidence that the decent
intended to kill himself or herself.
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11. TYPES OF SUICIDE
Egoistic suicide
Response of the
individual who
feels separate
and apart from
the mainstream
from the society.
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12. Altruistic suicide
 It is the opposite of egoistic
suicide
 The individual is
excessively integrated into
the group
 The individual will sacrifice
his/her life for the group
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13. Anomic suicide
It occurs in response to
changes that occur in an
individual ‘s life that
disrupt feelings of
relatedness to the group
eg: Loss of job, divorce
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14. Fatalistic suicide
occurs when individuals
are kept under tight
regulation. These
individuals are placed under
extreme rules or high
expectations are set upon
them, which removes a
person's sense of self or
individuality.
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15. RISK FACTORS FOR SUICIDE IN SPECIAL
POPULATION
 Hospitalized depressed pateint’s
 high level of anxiety
 First week of admission
 First month after discharge
 Elderly patient's
 Death of loved one’s
 Patient’s with alcoholism
 Lose of dear ones
 Substance use
 Late in course of illness
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16. RISK FACTORS FOR SUICIDE IN SPECIAL
POPULATION
 Depressed adolescent
 Loss of significant relationship
 Co-morbid substance use
 Prior suicide attempt
 Family history of major depression
 Previous anti depressant treatment
 History of legal problems
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FACTORS IN THE ASSESSMENT OF SELF
DESTRUCTIVE PATIENT
 Previous suicide attempt or received mental-
health services of any kind
 Excessive alcohol or other drug use
 Rational thinking lost
 Separated, divorced, or widowed (or other
ending of significant relationship)
Organized suicide plan or serious attempt
 No or little social support
 Sickness or chronic medical illnes

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PRESENTING SYMPTOMS
Hopelessness
 Decreased mood
 Agitation & restlessness
 Persistent insomnia
 Weight loss
 Suicidal thoughts & plans

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PROTECTIVE FACTORS AGAINST SUICIDE
Ability to cope with stress
 Effective and appropriate clinical care
 Support for help seeking
 Restricted access to lethal methods
 Cultural and religious belief that discourage
 Ongoing sense of hope in adversit

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NURSING DIAGNOSIS
 High risk for self mutilation
 Non- compliance
Potential for self directed violence
 Altered nutrition
 Ineffective individual coping
 Self esteem disturbances

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SUICIDE PREVENTION STRATEGIES
Decreases availability of lethal weapons
 Limitations on sale and availibility if alcohol &
drugs.
 Increased public and professional awareness
about depression and suicide.
 Less attention and reinforcement of suicide
behavior in media.
 Community based crisis intervention clinics
 Campaign to decrease stigma associated with
psychiatric care

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LEGAL ASPECT IN SUICIDE
 As per IPC
 Section 309- attempt to suicide can lead to one
year imprisonment and fine
Section 306- abetment to suicide lead to ten years
of imprisonment

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CONCLUSION
 Suicide assessment should be done continuously
during in-patient at the hospital either at admission,
home or any change in medication or other
treatments
 If you think a friend or family member is
considering suicide, you might be afraid to bring up
the subject. But talking openly about suicidal
thoughts and feelings can save a life.

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REFERENCES
Stuart, Principles And Practice of Psychiatric
Nursing, 10th edition, 2018,
 Mosby, St. Louis, Page.no.323-339
 Mary Townsend, Psychiatric Mental Health
Nursing,
 5 th. edition, 2000, Davis company,
Philadelphia, Page. No: 265-271
http://informahealthcare.com/doi/abs/10.3109
/00048674.2011.590465 DOA 16/02/2014

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