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40% of those who commit suicide have previously
attempted.
( Kerkhof 2000 )
1988 )
History of Deliberate Self Harm increases future risk of Suicide by 10 30 times. ( Gunnell & Frankel 1994) 50% of those who commit suicide have a history of self harm. ( Roy 1986)
England
N. Ireland
Wales Scotland
Suicide - Objectives
List the main reasons why people threaten suicide. Describe risk factors indicating potential suicide. Identify verbal clues which suggest suicidal intentions. Identify situational clues which suggest suicidal intentions. Outline behavioural clues which suggest suicidal intentions.
Suicide - Definitions
When a person takes their own life, whether with the assistance of others
or otherwise.
Or A deliberate act of Self harm which has caused the harmers death.
Suicide - Myths
They are all attention seekers. If they talk about it they wont do it.
I hope you have peace however you find it Maddy Good luck and I will see you on the other side. SIDHE
Gateway to Peace ?
Suicide - Myths
They are all attention seekers If they talk about it they wont do it Suicidal people are all Mentally / Physically ill Intelligent/educated people dont do it.
Suicide is the anchor point on a continuum of suicidal thoughts and behaviours. The continuum is one that ranges from risk taking behaviours at one end, extends through different degrees and types of suicidal thinking and ends up with suicide attempts and suicide. ( Redfield Jamieson 2000 )
Managing Disappointment
Critical Incident Debriefing S.W.O.M. Success / Ego
Secondary Reasons ( S.W.O.M. ) Cry for help Attention seeker Test reactions Gain something Manipulate events Prevent entry Intend to die Suicidal desire impulse levels increasing
Suicide Indicators
Refuses to talk Isolated - hopeless - helpless Specific death plan Deadline - last request No ifs or buts Commitment to die
Verbal / Situational
Police Negotiator should : Attempt to assess the subjects determination to complete the act and
Antecedent history Location Secluded / public Danger Convenient / Difficult Personally symbolic Special meaning. Socially symbolic Erskine Bridge Low self-esteem Emotional crisis Major life - marital - relationship events (last 24hours) Negotiator detects sense of hopelessness
Hostile threatening. Demands to be killed . Demands should be viewed as unsatisfied need. Past attempts. Final ritual - last will & testament. Inappropriate calmness - happy and content. Stripping of possessions relationships. Mental health. Method - slashing, cutting, firearms.
Offensive v Defensive threats Offensive If you dont get my wife ..I will jump Defensive If you try and grab me I will jump
Safest Possible Way Early Non-threatening I know that you are not ready to come down just yet, but when you do could you come to the centre of the roof / fire escape etc.
Resolution
Domestics
Resolution
Empathy Be patient for replies Beware of sudden movements Discuss real world v abstract Postpone action instead of changing mood Beware suicide by cop
Resolution
Try to resolve without meaning another failure Talk of successes Raise esteem
Resolution
Anti-social: in contact with reality Egocentricity in mind Be firmer to gain respect Safe release to his advantage Reality checks Avoid intermediaries Saving face coming out plan
Resolution
Provide a solution
Legal and media observers
Appeal to reason
Resolution
Terrorists
Excess will now diminish your message Youve made your point The World is watching Come out only choice left to them
IF CLUES SUGGEST SUICIDE - ASK! It looks to me as if you want out of this Visible - audible relief Motive? - purpose? Language implies suicide Why do you want to kill yourself How/when do you plan to do it? What have you done?
One negotiator? Active listening. Speech - slow, clear, simple . Personal concern - empathy trust.
Discourage alcohol/drugs. Establish problems - break down issue(s). Focus on situation - talk directly about it.
Rationalise.
Bid for time. Identify hook .
SUICIDE INTERVENTION
Allow to ventilate Try to get person to describe events as objectively as possible Place more objective, rational view of events Use empathy, point out the normality of reaction Raise esteem Ask how they have handled it in the past Ask to go over options they have ruled out AVOID lecturing/moralising/giving advice
them going
Bid for time, explore developing a realistic plan of
action.
Method
Help
Hindered Making the situation more volatile. Provided audience for suicide or verbal will.
Suicide audience
Hostages - no hostages Briefing - control
Importance of briefing
Personal safety - gather intelligence No deception
Dissonance
Personal
Interpersonal
Distance
Active Discussion
Projection
Blocking
Detachment
Sharing
De-personalisation
Rationalising Own personal crisis
Reflective Practise
Team Action Acceptance