Suicide is now the second leading cause of death among Americans age 10 to 34. Nationwide, emergency department visits for suicide attempts and suicidal thoughts doubled among youth between 2007 and 2015, according to JAMA Network. The median age of these patients – 13 – was younger than might be expected.
Nurses are in a unique position to help, according to Nurse.com. Because they're so directly involved in patient care, they can pick up on cues that can be reported and acted upon by nurses and other members of the healthcare team.
"Somebody dies from suicide every 40 seconds. It's a community problem," said Dr. Laura Shannonhouse, assistant professor in the department of counseling and psychological services at Georgia State University. Nurses can help prevent suicides through intervention training, she added. Shannonhouse recommended ASIST (Applied Suicide Intervention Skills Training), which is used by many healthcare providers. It enables nurses and others to build a safety framework for people who are thinking about or planning suicide. ASIST provides a clear model and is a tool that can be used to promote hope.
"It's actually the only suicide training that's evidence-based," Shannonhouse noted. "It's worth its weight in gold. If you're a nurse, it takes all the fear out of talking about suicide."
Patients are actually at increased risk for suicide when they leave the hospital, so follow-up care is also needed to help buffer this risk. And that foolow-up needs to be meaningful and go beyond a "just checking in" type of call.
The following tips from AmericanNurseToday, NursingCenter and Nursing2019 can also assist nurses in preventing suicides:
Recognize that talking helps and won't increase the likelihood of suicide
It's often believed that talking about suicide will increase its likelihood, but this isn't true. Talking helps nurses identify patients who are considering suicide while helping them reflect on their thoughts and take in new information that can help them think about things in a different way.
Be aware of risk factors
Nurses should assess patient histories and note risk factors for suicide. These can include substance abuse, grief, isolation or being the victim of violence or abuse.
Build a collaborative relationship
Trust is the key to effective communication, which in turn can lead to effective care.
When in doubt, refer for a more extensive evaluation
If a patient has had suicidal thoughts, particularly if they involve specific means or plans, they should receive a more extensive evaluation from a mental health services provider. Nurses should err on the side of caution and refer the patient for additional help even if they're not sure it's necessary.
Help create a safety plan
Work with the patient and colleagues to devise a safety plan to help him or her handle anxiety and negative thoughts.
Take preventative steps
A patient who has formulated a plan to end his or her life should never be left alone in the hospital. Mental health staff should be notified and the patient should be under continuous one-on-one supervision. Nurses should stress that the supervision isn't punitive but is instead for the patient's safety.
If you or anyone you know is contemplating suicide, call or text the 24-hour hotline at 800-273-8255. For more information, go to www.suicidepreventionlifeline.org.
- Suicide prevention resources for parents, guardians and families
- Suicide prevention resources for teens
- Suicide prevention resources for survivors of suicide loss
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