December 2012
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In This Issue
July 2014

Did You Know?

Suicide Risks in Medical/Surgical Hospital Units

Top List

Top 10 Important Suicide Statistics

Recommended Readings
Now Trending

Suicide Myths and Facts


Recommended Courses*
  • #60114 Elderly Populations and Suicide
  • #42914 What Everyone Needs to Know about Preventing Suicide
  • #38714 / #63114 QPR for Social Workers: Ask a Question, Save a Life
  • #111713 / #321113 Suicide Prevention: Chronic Respiratory Conditions

* course numbers may vary by facility


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Did You Know?

Suicide Risks in Medical/Surgical Hospital Units

In 2010 the CDC listed suicide as the tenth leading cause of death in the U.S. It is the third leading cause among persons age 15-24, second for those age 25-34, fourth for the age 35-54 group, and eighth for those 55-64 years of age. An estimated 8.3 million people per year have suicidal thoughts and 2.2 million reported having made plans to commit suicide in the past year.

In 2010, The Joint Commission issued a Sentinel Event Alert warning hospitals of the dangers of patient suicide in medical/surgical units and emergency departments. In the alert, The Joint Commission reported 827 reports of inpatient suicides since 1995, making suicide one of the top five most frequently reported sentinel events. While psychiatric settings are designed to be safe for suicidal patients and have staff with specialized training, non-psychiatric units in hospitals and emergency departments are not designed for suicide risk and often do not have staff with training to deal with suicidal patients. In these areas patients often have access to items that can be used, and have more opportunities to be alone to attempt suicide.

A Joint Commission National Patient Safety Goal requires hospitals to identify individuals at risk for suicide, along with the appropriate treatment environment and safety needs, and provide the patient and family with suicide prevention information at discharge. The National Quality Form lists suicide, suicide attempts, and “self-harm resulting in serious injury” as a Serious Reportable Event. In addition, Medicare has placed inpatient suicide on the list of “never events” for which, costs associated with suicide and suicide attempts will no longer be covered by Medicare and many private insurers.

Physicians, nurses, and other healthcare professions should be aware of risk factors, warning signs, and common characteristics of individuals at risk for suicide.

Risk Factors:

  • A current or past history of depression, bipolar disorder, substance abuse, schizophrenia, personality disorders, anxiety disorders, and impulsive/aggressive tendencies
  • Individuals age 65 and older have the highest rate of suicide and 20% of all death in adolescents are by suicide
  • Males are four times more likely than females to commit suicide and make up 78% of all suicides in the U.S. Suicide rates are highest for women age 45-54.
  • Previous suicide attempts
  • Family history of suicide
  • Chronic illness and terminal cancer
  • Chronic pain
  • Stressful life events, such as: losing a loved one, financial loss, or trouble with the law
  • Prolonged stress, such as: unemployment, relationship conflict, harassment, or bullying
  • Lack of a support system: single, divorced, and widowed individuals are more likely to commit suicide than those that are married

Imminent Warning Signs:

  • Hopelessness/no sense of purpose
  • Withdrawing from family and friends
  • Mood swings
  • Anger, anxiety, irritability, rage
  • Substance abuse
  • Sleeping too much or too little
  • Organized plan
  • Seeking lethal means
  • Making statements, such as: “I’m going to kill myself,” “I’m tired of living and I just want to die,” “People will be better off without me,” “Dying would solve my problems”

Although patients may not voluntarily report suicidal thoughts or plans, 70% will share their intentions when asked. When risk factors or warning signs are noted, it is important to make specific inquiries using a compassionate, non-judgmental tone with questions such as:

  • Do you ever feel like life isn’t worth living?
  • Have you ever thought about ending your life?
  • Have you ever attempted suicide?
  • Are you currently thinking about ending your life?
  • Do you have a suicide plan?
  • Can you tell me about your plan?

Risk factors and warning signs should be immediately communicated to a clinical manager, supervisor, or primary physician. Hospitals typically have policies which address the care of suicidal patients. The Joint Commission recommends hospital staff be empowered to call a mental health professional or other resource who can assess a person at risk, and take action to prevent suicide in those patients with imminent warning signs. For example: removing access to dangerous items that could be used to commit suicide; and/or placing the patient under constant observation or in an environment with fewer hazards.


Top 10 Important Suicide Statistics

  1. There were 38,364 suicides in 2010 in the U.S. – an average of 105 every day.
  2. From 1999 to 2010, rates of suicide increased by 28% for adults age 35 to 64.
  3. An estimated 1 million adults reported making a suicide attempt in the past year.
  4. About 1 person every 13 minutes commits suicide in the U.S.
  5. More people die by suicide than in car accidents.
  6. There is approximately 1 suicide for every 25 attempted suicides.
  7. Over half of all suicides are completed with a firearm.
  8. The strongest risk factor for suicide is depression.
  9. 80% of people that seek treatment for depression are treated successfully.
  10. Suicide results in an estimated $34.6 billion in combined medical and work loss costs.

Now Trending

Suicide Myths and Facts

People who talk about suicide are just trying to get attention or manipulate others.
Myth or Fact?

People who attempt suicide and survive often make additional attempts.
Myth or Fact?

Restricting access to dangerous items won’t help. People will find another way.
Myth or Fact?

Therapy and medications won’t help.
Myth or Fact?

Most people who are suicidal don’t want to die, but they just want to stop their intense mental or physical pain.
Myth or Fact?

You should never ask someone if they are thinking about suicide because talking about it may give them the idea.
Myth or Fact?

Sometimes suicidal people suddenly show improvement and seem to feel better because they have decided to die by suicide, and may feel relief knowing the pain will soon be gone.
Myth or Fact?


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Myth

People who commit suicide usually talk about it first. They often reach out for help because they don’t know what to do and have lost hope. You should always consider it serious when someone talks about committing suicide.

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Fact

Death seems to be the only way to escape the mental and physical pain, but interventions that improve contributing factors save lives. Suicide can be prevented.

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Fact

People with previous attempts are at a higher risk for suicide.

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Myth

Asking about suicidal thoughts or intentions gives the person an opportunity to share their troubles, which may help alleviate pain and cab trigger life-saving interventions.

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Fact

It is important to continue interventions to prevent suicide when a person suddenly seems to feel better or depression suddenly improves.

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Myth

Limiting access to lethal means of suicide is the best strategy for suicide prevention. Many suicides are impulsive and are triggered by an immediate crisis. Separating someone in a crisis from a lethal method can give time for the person to change their mind, the crisis to resolve, or someone to intervene.

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Myth

One of the best ways to prevent suicide is by getting treatment for depression, bipolar illness, substance abuse, and learning ways to solve problems and cope with stress.

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