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Thursday, February 27, 2020

Let's Talk About Suicide

suicidal thoughts
Since that is usually the exact opposite of what people tend to do when encountering an individual with suicidal thoughts. It's kind of a quiz, but I give the answers immediately after the question.

Usually a person planning to commit suicide displays some warning signs. Unfortunately it is often only in hindsight that these are recognized. Which of the following is NOT an early warning sign that a person may be intending to suicide?
1. Changes in sleep pattern
2. Giving away possessions
3. Withdrawing from family and friends
4. Making plans to attend a family function

4. Making plans to attend a family function
There are many behaviours that could suggest a person may be contemplating suicide. Some of most common include; changes to eating habits, sleep pattern, personal hygiene or drug use; risk taking behaviour; expressing thoughts of hopelessness, helplessness or despair; feelings of guilt, failure or shame; an increased interest in suicide or death; making arrangements for loved ones or pets; or having suffered a recent bereavement or other loss (e.g. job or relationship). It is crucial that anybody experiencing any of these symptoms receive help immediately.


Given that depression is the highest risk factor of suicide, once a person starts receiving treatment for depression they are immediately at a lower risk of suicide.
A. True
B. False

B. False
The risk of suicide is actually higher once a person's mood begins to lift. This is because a person suffering from major depression can be very lethargic, and although they may desire to die, they simply do not have the energy to attempt to harm themselves. Once treatment is commenced they may find they have more energy, though as they are not yet properly treated for depression, their outlook on the future remains hopeless.

In the United States of America the most common method of suicide is by firearms, which accounts for more than half of all deaths. Access to guns in Canada is limited and use of a firearm to commit suicide is the fourth most common method. What method accounts for the highest proportion of suicides in Canada?
1. Drowning
2. Hanging
3. Cutting (e.g. wrists)
4. Carbon Monoxide poisoning

2. Hanging
Methods of suicide differ depending on the age and sex of a person. For males in Canada hanging is the most common method of suicide (38%), followed by carbon monoxide poisoning (24%), firearms (14%) and other poison (9%). For females, hanging is also the most common method (30%), followed closely by poisoning by liquid or solid (27%), carbon monoxide poisoning (19%) and jumping (5%). Drowning and cutting contribute to less than 1% of all suicides.

Often people don't want to ask a loved one if he or she is thinking of suicide as they are afraid they will "put the idea in their head". This is not the case, and is an important question to ask. Once you have established that a person is suicidal, what is the next important thing to ask?
1. How they could be so selfish
2. How they plan to commit suicide
3. Why they plan to commit suicide
4. Why they are depressed

3. How they plan to commit suicide
While a person with vague suicidal thoughts is at a high risk of committing suicide, a person with an actual plan of HOW they will commit suicide is at an extreme and imminent risk. This is especially true if the method is easily available and they have set a time. This does not mean that a person without any well thought out plan will not attempt suicide, and indeed a person with only passive suicidal ideation (e.g. I wish I would just die in my sleep) is still at risk of suicide and in need of immediate professional attention.

OK, you have established that your friend is suicidal. Under what circumstances would it be safe to leave them alone?
1. If they are in their own home
2. If you need to go to work or school
3. They shouldn't be alone
4. Once they appear happier

3. They shouldn't be alone
A person who is actively suicidal should not be left alone at all. Even the average bedroom contains items such as sheets, electrical cords, belts and shoelaces that can be used in an attempted hanging. If you are unable to stay with them, arrange for another trusted person to be with them or take them to where they can see a mental health professional. A sudden change in mood from depressed to happy or at ease is a warning sign for suicide. Often once a person makes the decision to suicide, they feel relieved as their perceived problems will soon be over.


What should you NOT do if a person tells you they are having suicidal thoughts?
1. Promise to keep their secret
2. Be willing to listen
3. Talk openly and directly
4. Take them seriously

1. Promise to keep their secret
A person with suicidal thoughts often believes that he or she is beyond help. You are not violating a privileged communication by talking to a mental health professional in order to ensure they receive the help they need. All suicide threats should be taken seriously. Although it can be difficult, it is important not to judge the person and to discuss the topic freely without showing shock or disapproval.

Never used on its own, a suicide contract is a tool that can be utilized in the long term management of a person with suicidality. A suicide contract can be a verbal agreement, but more commonly is a written contract signed by the person at risk of suicide. The contract will obviously include a clause not to harm themselves, but what else should be included in the contract?
1. Information about depression and symptoms
2. A list of reasons not to commit suicide
3. Names and phone-numbers of support people
4. Legal terminology

3. Names and phone-numbers of support people
A suicide contract is NOT a guarantee that a person will not commit suicide, and is always used in conjunction with counseling and/or medication. While a medical practitioner may use a suicide contract, its effectiveness in preventing suicide has not been clinically proven. A suicide contract can however be useful in establishing rapport and trust between the clinician and client. If it is decided that a suicide contract would be useful, then the contract should be as simple as possible, including a guarantee not to suicide and who to contact if the person is feeling suicidal. The contract should be kept in an easily accessible area in the home.

A person's risk of suicide is increased if he or she attempted suicide in the past.
A. True
B. False

A. True
Past suicide attempts are one the major risk factors of suicide, and recent attempts are of particular importance. This is one of the first questions a mental health professional will ask when assessing a person's suicide risk. Having a family member who has committed suicide is also a risk factor.


Suicidal thoughts are often a symptom of depression. CBT, used in conjunction with medication, has been proven effective in treating depression. What does CBT stand for?
1. Cognitive behavioural therapy
2. Comprehensive brain therapy
3. Complete behavioural therapy
4. Computerized brain tomography

1. Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is a form of psychotherapy for people affected by mental illness. CBT involves a qualified health professional talking to the person about their symptoms, and working on alternative ways of thinking about and coping with them and their effects.

Along with grief, family and friends may feel stigmatised and isolated after a suicide death. What would be a helpful response to a person in this situation?
1. All of these answers
2. Be aware of difficult times such as anniversaries or holidays
3. Talk about the person who has died
4. Listen without judging

1. All of these answers
Just being available to listen is the most important thing you can do. Suicide usually comes as a shock as the death is not expected, and the survivors need time to grieve. There still remains a social stigma attached to suicide that family members may have to deal with. Offering practical support such as shopping or cooking and finding information on support groups is another way you can help. Remember suicide is preventable.

**About 3,600 people commit suicide in Canada each year. That's about 10 suicides per day.
**About four times more men will commit suicide this year than women.
**Women make 3 to 4 times more suicide attempts than men. Women are also hospitalized for attempted suicide at 1.5 times the rate of men.
**For every suicide death, there are an estimated 20 to 25 attempts.
**Canada has a suicide rate of about 11 per 100,000. That's a slightly higher rate than the U.S.
**Canadians are about 6 times more likely to commit suicide than they are to be a victim of homicide.
**For people between the ages of 15 and 44, suicide is the fourth leading cause of death.
**The most-common method of completed suicide in Canada was suffocation, principally hanging. These account for 40 per cent of completed suicides. Poisoning, which includes drug overdoses and inhalation of motor vehicle exhaust, is the next most-common.
**By far, the most common method of self-injury and suicide attempts leading to hospitalization is poisoning.
**Suicide rates for the immigrant population are about half those for the Canadian-born.
**Suicide accounts for 24 percent of all deaths among 15-24 year old Canadians.
**Suicide is the second leading cause of death for Canadians between the ages of 10 and 24.
**The rate of suicide among Aboriginals is twice the national rate. Among women, the rate of suicide for Aboriginal is three times the national rate.

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