Suicide and selfharm

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Suicide and self-harm

• Dr. Simon Hatcher
• www.shatcher.co.nz

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Suicide as a moral problem

• Suicide - the word
• Christian and other world views

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Suicide as a social problem

• Durkheim
• Suicide a study in Sociology

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Suicide as a medical problem

• 90 of individuals who kill themselves have a
  psychiatric disorder

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Suicide deaths and rates
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Suicide death rates, by sex, three-year moving
averages, 19862006
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Suicide age-specific death rates 2006
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Age-specific suicide rate, by age group,
three-year moving average, 19212003
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Maori and non-Maori suicide death rates, by sex
1996-2006
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Suicide deaths by ethnicity, age and sex 2006
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Deprivation Suicide numbers and age-standardised
rates by NZDep 2001 quintile and sex, 2006
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Methods of suicide deaths 2006
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Method of death for suicides in the Auckland
Coronial Region1989-1997
Number of suicides
METHOD OF DEATH OF SUICIDES
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(No Transcript)
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Suicide death rates, by District Health Board,
20022006
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Age-standardised suicide rates for selected OECD
countries, males
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Nomenclature

• Attempted suicide
• Parasuicide
• Deliberate self-harm (DSH)
• Self-harm

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Why is self-harm important?

• Common
• Relationship to suicide
• Increase in mortality from all causes
• Significant comorbidity

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Hospitalisation for Intentional Self-Harm 2001/2

• Ministry of Health

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Relationship to suicide

• 25 of people who commit suicide have a history
  of self-harm in preceding year
• 1 of people who intentionally self harm suicide
  per year
• Different epidemiology and relationship to mental
  illness

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Numbers and episodes of self harm in four DHBs
in 2006
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Rates of self harm
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Age distribution of people presenting with
intentional self-harm to four DHBs
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Four Level Intervention Model
Who is involved?
3-12 of population
SPECIALIST SERVICES
20-30 of population
EARLY INTERVENTION
At risk groups
PREVENTION OF PROBLEMS
Entire population
PROMOTION OF WELL BEING
(Adapted from WHO Four level approach to School
Change)
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The prediction of suicide

• PPV1.7 (18/1018) Sens90 Spec99

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Assessment after self harm

• Aims
• Engagement
• Understand the patients wish to die
• Assess future risk
• Identify risk factors for harm (especially
  modifiable maintaining factors)
• Create management plan that addresses risks
• Diagnose psychiatric disorder if present

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References

• www.spinz.org.nz suicide prevention New Zealand
• www.moh.govt.nz/suicideprevention - Ministry of
  Health site with NZ statistics
• www.shatcher.co.nz personal website with
  suicide and self harm info plus teaching materials