Suicide

Nurses and midwives may encounter suicide in their work as health care professionals, as well as personally through people they know or individually through their own experiences.
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Who to call
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If you are concerned that you, or someone close to you, is feeling suicidal, or showing signs of suicidality there are a range of services and support options available to you. This includes our confidential support line you can call us anytime on 1800 667 877.

You can also contact:

 

Suicide and Health Professionals
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In 2016, a retrospective study was released entitled Suicide by Health Professionals, A Retrospective Mortality Study in Australia from 2001 to 2012 by researchers led by Deakin University’s Dr Allison Milner. The results of the national study highlighted these four stark findings:

  1. Female medical professionals are 128% more likely to suicide than females in other occupations.
  2. Female nurses and midwives are 192% more likely to suicide than females in other occupations.
  3. Male nurses and midwives are 52% more likely to suicide than males in other occupations.
  4. Male nurses and midwives are 196% more likely to suicide than their female colleagues.

The study states that some of the reasons for the higher rate of suicide by female and male nurses is the particularly demanding nature of the job. Contributing factors such as long hours and work/life balance play a prominent role, with anxiety also being a potential risk factor for suicide.

It’s really important for nurses, midwives and the organisations that support them to appreciate the complexity of what they do and look at the ways in which we can work on our health and cultural health to prevent suicide.

Signs of suicidality
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It’s really important to address the uniqueness of each individual who experiences suicidal thoughts. Having an environment where a person feels comfortable and has that capacity to talk about their thoughts and feelings can play an important role in helping people find help.

In terms of mental health risk assessments break it down into three factors.

  • The ideation, the thoughts that a person may have in terms of suicide.
  • The plan, understanding what that plan may be.
  • The intent. Within that, you can really capture what’s going on.

Beyond Blue developed this list of behavioural and physical changes that someone can present with.

Non-verbal indicators, may be:

  • social withdrawal
  • a drop in mood
  • disinterest in maintaining their own personal hygiene or appearance
  • reckless behaviour
  • poor diet, rapid weight loss
  • being distracted
  • anger
  • insomnia
  • alcohol and drug abuse
  • giving away sentimental or expensive possessions

Some of the indirect verbal expressions may include:

  • hopelessness
  • failing to see a future
  • believing they are a burden to others
  • saying they feel worthless or alone
  • talking about their death or wanting to die

This is not an exhaustive list. Be guided by your own instincts and what you know about the person.

What are the risk factors for suicide?
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Each person is unique but risk factors may include:

  • Previous suicide attempts
  • History of substance abuse
  • History of mental health conditions (like depression, anxiety, bipolar, PTSD)
  • Situational events (relationship problems, familial conflicts, conflicts at work, legal and disciplinary problems)

As well as that, other risk factors can be the access to harmful means (such as medication). There are some common themes as well in terms of:

  • Recent deaths or suicide of close friends
  • Ongoing exposure to bullying behaviour
  • Physical illness or disability

In relation to risk factors it’s important, to be cautious and acknowledge that it’s very complex. The factors of influence for someone can vary.

Things that may reduce the likelihood of suicidal behaviour and improve the person’s ability to cope with different circumstances include:

  • Social connectedness, having peers that you can trust and talk to
  • Family members, a child.
  • Motivation for an event

It can be quite complex to quite simple protective factors that also have an influence in terms of a person and their risk of suicide./p>

What to do if you suspect that a friend or colleague is at risk of suicide?
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A lot of the research indicates that talking about one’s suicidal thoughts can be are relief to a suicidal person. It gives them a chance to talk about their problems and put them in a space where they feel like somebody cares for them.

Another thing that we know is that although we know that health services play an important role in helping people at risk, research indicates that many people who die by suicide are not in contact with a health service in the month before their death.

So, in terms of the discussion, what they speak about is that it’s important to know that everyone of us is likely to have a close contact with someone who is suicidal. It’s important for us to get to a point where we feel comfortable talking about these things. They talk about a very simple three step process.

1. Talk to someone, directly, about their suicidal thoughts and intentions in regards to suicide.

The important thing when you’re asking these questions is to avoid leading in judgemental ways. Using statements like, “Are you having thoughts of suicide?” Or, “Are you thinking about killing yourself?” With the aim that, hopefully, asking someone about their suicidal thoughts will allow them the chance to talk about their problems and show them that somebody cares.

It’s ok if you feel a bit nervous, it is a really hard thing to talk about. Ask questions that open with, “Are you…” instead of saying things like, “You’re not thinking about doing something stupid…” By having the conversation at all you will help them feel better.

2. When you listen to someone’s response, do it without that judgement.

You let them talk about why they want to die, and this can cause relief. Don’t try to convince a person that suicide is wrong, or tell them that it will hurt people if they die, because this can really shut down communication and the opportunity for the person to get support.

3. Really emphasize to the person at risk that you, as an individual, care and want to help them.

Ask them how they would like to be supported. Is there anything that you can do to help?

Training is available
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Mental health first aid training is a wonderful way in which people can get some development, education and familiarisation. It can really help with getting the literacy, but also the comfort from working in this space.

Similar to basic first aid that addresses a cut or a bruise or a snakebite, it gives us the basics on people’s mental health and helps us overcome the obstacles that we all naturally have. It’s a wonderful way of helping in terms of changing the culture from something that’s hidden to something that you can freely speak about in your organisation.

Recognising as a nurse and a midwife the expectation is the fact that there’s a lot of stressful things that we will see and witness. The trauma that one will see, and witness, there are ways to continually work healthily in these areas as well as manage it and have support through therapy and supervision. Whatever it may be, it’s acknowledging that we’re not invincible. We can’t be.

What should a nurse or midwife do, if they feel suicidal? What supports are available?
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You are not alone. You may often feel alone and incredibly isolated. You maybe struggling to connect to your networks. Or you feel so helpless that you don’t. It’s really important to know that there are lots of different services available to support you. It depends on how comfortable you feel with speaking to another person about how you feel.

If you can it’s really good to be able to speak to your family, friends and colleagues. If you can’t, your GP is a good starting point, they can help by creating a mental health care plan and refer you onto other mental health care professionals.

If that’s too much, then there’s other services like:

Nurse & Midwife Support is also available for people who are experiencing these thoughts. We provide peer to peer based support and acknowledgement in that space.

There’s also emergency support. Going to a hospital, all of our emergency departments are equipped to be able to support someone who isn’t feeling safe.

It’s just about finding something, whatever suits the individual is the right thing. The hardest thing is often just making that first call or having the first discussion.

After someone you work with dies from suicide what are the ways to manage this? What support is available for workplaces?
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This can be an incredibly traumatic time. There are 2 important components:

  • There’s your individual needs: as a person who is going through this.
  • Then there’s the organisational and how management can support this.
Organisation
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When it comes to a co-worker dying or even attempting suicide and surviving, there can be those overwhelming feelings of guilt and grief. It’s also important to know that it can also impact those within the organisation.

They may not even be close to that employee. So, employers need to really consider these impacts to the overall psychological health and safety of their workplace. There’s a whole range of factors, a lot of employers have a whole range of processes that they go through.

Be aware of your co-workers’ reactions and how it’s impacting them. Provide a collaborative response, whether it be through grief counselling or group trauma or individual counselling. Each staff member’s reaction can vary significantly from employee to employee. People respond differently. People respond at different times. People are triggered by different things.

Managers can also feel huge amounts of guilt and grief related to a suicide death.

Providing education is important. Improving people’s ability to undertake mental health first aid is a good example.

Organisations should determine if there are any workplace factors that are associated with the death and address them immediately.

Some organisations have a tribute to the person who died which can help people with processing.

Individuals
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For nurses and midwives who are naturally focussed on the care of others, it’s really important to be mindful of the impact that this is having on you.

It’s important to give yourself permission to be healthy. Take time and breaks for reflection and healing and recovery for yourself. It’s important for all of us to have permission to do that. We’re all individuals and we all have different grief responses. It’s that balance between not minimising your own grief because you want to help and be of service, or you feel that you have a responsibility to do so. It’s about acknowledging your own needs. But also, not being concerned because you’re not reacting that way. We’re all incredibly individual and different and there’s no right or wrong way to go through a healing process.

Acknowledge
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It’s important to acknowledge those who have been impacted by suicide. Suicide is prevalent in our nation and we hope that these resources are useful There’s very few people who haven’t been touched by the impact of suicide.

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