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o Second only to MVA as cause of death – but still uncommon.
o 3 fold rise in last 30 years.
o Females attempt, males succeed
o Second highest rate for 15-24, Finland higher
· Postulated factors contributing to increase:
o Depression and substance abuse
o Isolation and alienation
· Key issue: identifying those at risk
· Risk factors:
o Male gender
o Psychiatric illness: depression (most common association), alcohol or substance abuse, personality disorder, psychosis
o Previous suicide attempts
o Available means: firearms, toxic medications
o Social adversity: recent interpersonal loss, homelessness, school failure or drop-out, family or relationship problems, unemployment
o Recent exposure to suicide
· Most common presentations are over-dose, self-poisoning and lacerations
o Treat underlying psychiatric disorder (not TCAs – too lethal in overdose. Use SSRIs)
o Reduce ongoing stress: counselling to reduce interpersonal conflict
o Promote social supports
o Liase with specialist health services
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