Suicide A Failure of Communication

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SuicideA Failure of Communication
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• One million deaths annually from suicide
  "global" mortality rate 16 per 100,000, one
  death every 40 seconds.
• Suicide one of three leading causes of death
  15-44 years
• Suicide attempts 20 x gt completed suicide.
• Suicide 2 of the total global burden of disease.
  
• Youth highest risk in 30 developed and
  developing countries.
• 90 Mental disorders (depression, substance
  abuse)
• Complex socio-cultural factors
• Socioeconomic crisis (loss of loved one,
  employment, honour).

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Rates
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Gender Differences
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Myths and Gestures

• Suicide / attempted Suicide / Para Suicide
• Completed acts more males
• Cry for help more female
• Mistake to look at completed deaths - add both
  attempts and deaths

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Suicide / Para Suicide

• Different methods males guns / females poisons
• Females roles / taboos
• Misdiagnosis accidental firearm deaths (Israeli
  soldiers)
• Less lethal poisons - India insecticides etc and
  less likely to survive

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Causes of Suicide

• Multiple factors build to threshold
• Sadness, hopelessness, despair, depression
• Pain and hurt, feeling different, unwanted
• Bullying, abuse, anger, rage
• Cry for help , unheard, frustration
• trigger incident row, failed exam ..
• Availability of method (gun, drugs etc)

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Communication -Areas to Consider

• Attitudes and reactions to death / suicide of
  another
• Reaction of Peers
• Reaction of Parents
• Attitude towards own death

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Facing the reality of death
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First Reactions

• Mixed Emotions
• Disbelief
• Denial

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Making Sense of Nonsense

• Why?

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Finding False Answers

• Blame
• Responsibility

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Self Punishment

• Guilt
• Self deprecation
• Unloved
• Unworthy

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Work Through Loss

• Failure to deal with death / suicide
• Failure to work through loss
• Leads to harmful emotional consequences
• Risk of repetition / replication

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Working through loss / hurt
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Justification

• Blocks to working through loss
• Over identification
• Denial
• Justification
• Keep a sense of reality - remember their good
  points and their bad points - but most of all
  remember that they did this because they were in
  pain, they were disturbed, upset and could not
  cope with life. It is a sadness that they were
  not able to deal with life, that they were not
  helped to cope with their problems.

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Heroes and Copycats
Death of Chatterton
'Cut is the branch that might have grown full
straightAnd burned is Apollo's laurel bough.'
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Myths
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Suicide is a form of self harm.

• Not looking after yourself
• Putting yourself in danger or taking risks
• Harming your body with drugs substance abuse or
  alcohol.
• Not eating depriving your body of what it needs.
• Over eating
• Hurting or harming yourself - cutting,
  scratching.
• Suicide gestures
• Suicide

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Cry for Help?

• Missed Communication
• Not being heard
• Frustration Anger Fury
• Revenge

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Suicide is a vengeful act

• Suicide is an aggressive act - it hurts people
  around us - it leaves behind pain and
  destruction.
• It is not just self harm it also harms others -
  especially harming those close to us.
• Suicide / homicide axis

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Adolescent Issues

• Immediacy precipitous action
• Lack of consequences
• Adolescent Invincibility
• Future time perspective
• Permanency of death
• A better place religion / taboos

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Tantrums and Hurt

• Need to hurt and strike out repercussions
• Theyll be sorry
• Hes gonna miss me
• Talk now!

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Barriers to Communication

• TRUST
• Trust ----- Betrayal
• Misplaced trust ------- set up for betrayal
• Untrusting ------- Untrustworthy

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Barriers to Communication

• Insecurity / Unpredictability
• Reaction to communication / Consequence of action
• Consequence of action ---- Predictable -----
  Security
• Consequence of action ---- Unpredictable ----
  Insecurity
• Consequence of action ---- Absent ----
  Worthlessness

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Communication

• Breaking silence
• Indirect communication
• Acting out
• Self Harming
• Delinquency
• HELP!!!

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Who are we taking to?

• PARENT
• ADULT
• CHILD

Indirect / covert communication more potent than
direct / overt
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Suicide risk - statements

• What is each statement really saying?
• Alternatives depending on
• way things are said and communicated
• who is talking
• Consider -
• pseudo adult / parent
• Vengeful child

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My family would be better off without me

• Depression / passive - watch for increased
  energy
• Vengeful attention seeking
• Family symptom scapegoat - DANGER

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Next time Ill (take enough pills to) do the job
right

• Dont think youve got away with it.
• P/C conflict /control issues
• You brought me into this world. Ill show you I
  can leave it. You cant control me. I can do this.

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I wont be in your way much longer

• Hints threats
• Little voice please help me

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Settling affairs- writing notes

• Doing it quietly dangerous serious
• Doing it flamboyantly - manipulation
• Karen Lady Macbeth attention seeking
• Laura quiet determination

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Risk Factors

• Feeling of not belonging
• Dont fit
• Not normal
• Different
• developmental issues
• sexuality

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Risk Factors Self Hatred

• Let everyone down
• Failure
• Cant live up to expectations
• Unpardonable sin

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Risk Factors

• Associated factors
• Abuse / Bullying
• Drugs / alcohol
• Sexual issues / identity
• Common thread .Secrecy / non communication
• Un connected

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Level of Communication

• PARENT
• Protection
• Guidance
• Affirmation
• ADULT
• Appropriate information
• CHILD
• Empathy

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Positive Communication

• Honestly listen , empathise and inform without
  denial or minimising.
• Dont avoid the word suicide
• Dont appear to judge suicide is not wrong -
  but is undesirable
• Be accepting of suicidal feelings without
  endorsing them

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Positive Communication

• Face reality together (future may be bleak)
• Find a positive focus (eg bravery, honesty,
  desire to find a solution, wish to help others)

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Other Considerations

• Consider your own feelings and agenda
• Are you minimising or reassuring to protect
  yourself

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Communicate

• The way to defeat and prevent suicide is to
  communicate, to listen to others and to talk to
  others when we have problems. The solution is to
  keep working on our problems, to have the courage
  to stick with life and to help others to do the
  same.

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Active Communication - Art
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Active communication - Art
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Active Communication - Drama
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Active Communication - Poetry