Recognizing the Signs of Suicide

The Ministry of Health through its work program, namely the Sustainable Development Goals (2015 Sustainable Development Goals/SDG) mentions the SDGs indicator on suicide. The SDG target is to reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being by 2030. The government carries out mental health promotive and preventive efforts through a life cycle approach (Continuum of Care) and Population at Risk and integrated at all levels of health services.

There are four steps in the suicide risk assessment, namely: (Sonia and Stan, 2007)

Step I Assessment of suicide

Initiate a suicide assessment. How to talk to patients to get information about the occurrence of suicide. Establishing an open communication relationship with the patient as an initial approach to any medical assessment but especially in the case of patients with suicide (suicidal ideation, suicidal plans and suicidal attempts). A calm, patient, non-judgmental and empathetic approach will help create a safe, comfortable environment for the patient.

Examples of empathy statements:

"I see how hard some things have been for you lately." "It seems that things have been difficult for you recently and these are difficult to overcome." "You seem to be having a hard time."

Step II Evaluate risk factors for suicide

Includes assessment of psychiatric history and psychiatric symptoms, hopelessness, medical history, family history and psychosocial history as well as personality strengths and weaknesses. This assessment component also provides an opportunity for clinicians to identify acute psychosocial crises and chronic psychosocial stressors currently affecting patients. It is often useful to do a rapid assessment of psychosocial stressors as part of the assessment.

Step III Identify what happened

Examples of the following questions: Why?, Why now? What is going on? Identifying the answers to these questions will help health screenings to understand the complexities of factors that underlie or trigger suicidal behavior. This in turn will facilitate the identification of targets for intervention.

Step IV Identify targets for intervention

Identification and target of interventions to reduce modifiable risk factors for suicide, namely treating disorders and symptoms of a diagnosis of psychiatric disorders, suppression of psychosocial situations by addressing modifiable triggers or triggers, character difficulties, namely maladaptive personality traits and coping skills.

Prevention according to Chu et al. (2010) develops theories and models of cultural approaches. There are four culturally relevant themes that are significant for suicide assessment and prevention:

1. Sanctions and cultural meanings, absorbing specific values ​​about the acceptance of suicide, and which lead to the development of attitudes towards certain life circumstances or situations such as acceptance of the risk of embarrassment, thus triggering. Cultural meaning determines how life's stresses are perceived and whether suicidal thoughts and intentions are likely to convert to suicide attempts.

2. Cultural uniqueness also influences to whom suicidal intent is expressed and how, and the ways in which suicidal attempts are manifested.

3. Minority stress refers to the distressing factors that society imposes due to minority status, social inequality, or persecution.

4. Social discord in social and community support acts as a triggering factor. Conflict and alienation affect individuals and increase vulnerability in proportion to the values ​​attached to societal and social support systems.

Let's have open communication with each other either in writing (through the SehatPedia Psychiatrist) or unwritten (come directly to the psychiatrist's practice or the psychiatric polyclinic at the nearest hospital). Open communication helps with problems and makes it easier to overcome or overcome them.