Page 87 - Retail Pharmacy Magazine October 2020

CPD ACTIVITY 85 Understanding suicide and early prevention strategies 2 CPD CREDITS potential suicide is averted. Early conversations also provide the chance to have ongoing conversations and interactions with the individual. Initially in your first conversation you may simply let the person know you are thinking of them and happy to chat at another time. Ongoing conversations may result in supporting them to further develop their action plan to address issues they are prepared to share with you as their level of trust in you increases. If you think suicide is an imminent risk, calmly and confidently ask the person: • Do you have a plan to kill yourself? • Do you have the resources to kill yourself? • Have you attempted suicide before? If they answer ‘yes’ to any of these questions, calmly and respectfully arrange for the individual to access immediate expert medical attention. While this person may not remember what you said or did, they will remember how you interacted with them and this can have a profound effect on feelings of self-worth and recovery. In all conversations, regardless of the level of acuity, respect, compassion and a genuine willingness to want to help a fellow human being greatly contribute to better outcomes for the individual and strengthen their hope for a better future. Bibliography Barnes MC, Gunnell D, Davies R et al. ‘Understanding vulnerability to self-harm in times of economic hardship and austerity: A qualitative study’. BMJ Open, 2016; 6: e010131. Brodsky BS. ‘Early childhood environment and genetic interactions: The diathesis for suicidal behaviour’. Current Psychiatry Reports, 2016; 18 (9): 86. Burns J, Blanchard M. 2014. International Literature Review on Mental Wellbeing & Resilience Relating to Young People and Communities: A report to VicHealth. Melbourne, Young and Well CRC. Coope C et al. ‘Characteristics of people dying by suicide after job loss, financial difficulties and other economic stressors during a period of recession (2010–2011): A review of coroners records’. J of Affective Disorders, 2015; 183: 98-105. Foster T. ‘Adverse life events proximal to adult suicide: A synthesis of findings from psychological autopsy studies’. Archives of Suicide Research, 2011; 15 (1): 1-15. Franklin JC et al. ‘Risk factors for suicidal thoughts and behaviours: A meta- analysis of 50 years of research’. Psychological Bulletin, 2016; 143 (2): 187-232. Iorfino J, Davenport TA, Ospina-Pinillos L, Hermens DF, Cross S, Burns J, Hickie IB. ‘Using new and emerging technologies to identify and respond to suicidality among help-seeking young people: A cross-sectional study’. J Med Internet Res, 2017; 19 (7): e247. Joiner TE et al. ‘The psychology and neurobiology of suicidal behaviour. Annu Rev Psychol, 2005; 56: 287-314. Keyes CL. ‘Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health’. American Psychologist, 2007; 62 (2): 95. Klonsky ED, May AM. ‘The three-step theory (3ST): A new theory of suicide rooted in the ideation-to-action framework’. International Journal of Cognitive Therapy, 2015; 8 (2): 114-129. Mendoza JA, Rosenberg S, Visser V. (2010). Breaking the Silence: Suicide and Suicide Prevention in Australia, Caloundra, Qld, ConNetica Consulting. O’Connor RC, Kirtley OJ. ‘The integrated motivational–volitional model of suicidal behaviour’. Phil. Trans. R. Soc, 2018; B 373: 20170268. Tatz C (1999). Aboriginal Suicide is Different – Aboriginal Youth Suicide in NSW, the ACT and New Zealand: Towards a Model of Explanation and Alleviation. Sydney Macquarie University. Wilkinson RG. ‘Commentary: Income inequality summarises the health burden of individual relative deprivation’. BMJ, 1997; 314 (7096): 1727. Zalsman G et al. ‘Suicide prevention strategies revisited: 10-year systematic review’. The Lancet Psychiatry, 2016; 3 (7): 646-659. Accreditation number: A2010RP3 (Exp: 30/09/2022). This activity has been accredited for 1 hour of Group One CPD (or 1 CPD credit) suitable for inclusion in an individual pharmacist’s CPD plan, which may be converted to 1 hour of Group Two CPD (or 2 CPD credits) upon successful completion of the associated assessment activity 1. Which of the following statements about the prevalence of suicide in Australia is CORRECT? A) Suicide is the leading cause of death in people aged over 44 years. B) Suicide rates are decreasing in most developed countries. C) Suicide in indigenous populations is consistently double that of the non-indigenous population. D) Social isolation due to Covid-19 has led to a decrease in suicide. E) Death from suicide is greater in women than men. 2. Which of the following can predispose an individual to suicidal thinking and behaviour? A) Adverse childhood experiences. B) Adverse life events. C) Limited access to services and supports in rural and remote areas. D) Natural disasters. E) All the above can predispose to suicidal thinking and behaviour. 3. Which of the following statements about early suicide intervention is INCORRECT? A) The wellbeing phase involves development of resilience, self- efficacy, meaning and purpose, and social connectedness. B) The motivational phase involves responding to emergence of suicidal thinking and behaviour intention formulation. C) Self-care and informal care in the community are the largest and least costly areas of care. D) Early suicide interventions require expert diagnosis before implementation. E) Suicide is rarely an impulse, most people who die by suicide have planned in detail. 4. Which of the following statements about assessing suicide risk is INCORRECT? A) Standardised checklists reliably simplify assessment of suicide risk. B) It has been suggested that an open dialogue and flexible approach based on motivational interviewing is an effective suicide screening mechanism. C) Emerging suicide prevention programs give skills to people in the community who are more likely to notice distress in those they have an ongoing relationship with. D) Communication with an individual at risk of suicide should be respectful and non-judgemental. E) Initiating the conversation about suicide involves open ended questions and showing genuine concern. 5. True or false? Provision of and access to quality mental healthcare, that is integrated and includes cross-sector health and community professions working together to deliver care in a non-stigmatised and respectful manner, has been shown to reduce suicide rates. A) True. B) False. RETAIL PHARMACY • OCT 2020