HALIFAX - A new suicide risk assessment tool used by health professionals in some Nova Scotia hospitals is a "valuable step" towards preventing suicide and should be implemented on a wider scale, a psychiatry professor says.
A task force led by Joseph Sadek of Dalhousie University recently developed a one-page form that arms mental health providers in the Capital District Health Authority and IWK Health Centre with a tool to identify a patient's level of suicide risk.
Under a policy implemented in early July, the form must be filled out by a mental health care provider for any patient who comes to a health centre with mental health concerns, said Sadek.
"The policy was basically aimed around a risk assessment that needs to be done, and when it's done and the patient is found to be at risk of suicide, then (determining) what can we do about it," Sadek said in an interview.
Sadek said the form is breaking new ground in suicide prevention as the 10th anniversary of World Suicide Prevention Day is being marked on Monday.
He said the Halifax-based task force had looked at similar tools in Europe and across North America.
"But there hasn't been a combination of the most important steps that need to be taken," Sadek said.
The form consists of a communication, management and monitoring plan, which can be implemented depending on the patient's level of risk.
If a patient is at a moderate or high risk of suicide, other physicians that person may be referred to must be notified of the risk.
'"There is some kind of direct warning that goes on to the next service... and we think this is very important," said Sadek.
The form may also call for a round-the-clock monitoring of the patient or a check-up visit in 24 hours.
But Sadek said it's hard to say if the tool has prevented suicide since the policy was implemented a few months ago.
"It's such a short time to do any...meaningful statistical analysis," he said. "In six months, we are going to collect some data and will have more (insight) into what is happening."
However, Sadek added that health care workers have found the tool very helpful and say it has increased their confidence in arriving at a conclusion about a patient's suicide risk.
Other health authorities in the province have shown interest in the form and Sadek hopes it will soon be implemented on a wider scale.
In Nova Scotia, psychiatrists who study suicide are placing emphasis on the importance of the health care provider's role in suicide prevention.
Earlier this year, Dalhousie psychiatry professors Stan Kutcher and Sonia Chehil wrote a well-received academic manual that educates health professionals on suicide risk assessment. Kutcher has also developed an online training program based on the manual for health professionals province-wide.
Sadek said teaching health care workers how to recognize people at risk of suicide is instrumental in preventing a death.
"Suicide is an extremely important topic and it's an issue that's devastating for families, physicians, for everyone. We need to take that issue very seriously," said Sadek.
"There should be a minimum basic education around suicide for everyone who is in the health care system."
According to the Canadian Association for Suicide Prevention, 86 people died by suicide in Nova Scotia in 2005.
Nearly 3,900 people committed suicide in Canada in 2009, Statistics Canada's website said.Are you in crisis? Need help? In Canada, find links and numbers to 24-hour suicide crisis lines in your province here.
<br>One way to sabotage yourself is to take a single event and treat it as an ongoing source of negativity. "People who are unemployed do this a lot," says Rego. "They've lost their job because of the economy and they personalize it." <br><br> It's also unhealthy to catastrophize--focus on the worst imagined outcome, even if it's irrational. For example, don't let concerns about money escalate into the conviction you'll soon be homeless.<br><br> Instead of thinking, "I'll never get another job," try to say to yourself: "I will get another job. It just may take some time."<br><br> <strong>More From Health:</strong> <br> <br><a href="http://www.health.com/health/gallery/0,,20515167,00.html" target="_hplink">12 Surprising Causes of Depression</a><br> <a href="http://www.health.com/health/gallery/0,,20581256,00.html" target="_hplink">Dos and Don'ts for Dealing with Anger</a><br> <a href="http://www.health.com/health/gallery/0,,20526304,00.html" target="_hplink">20 Celebrities Who Battled Depression</a><br>
Ever clash with a colleague or fight with a friend and then keep obsessively thinking about it, amplifying the anger, stress, and anxiety associated with the memory? Known as rumination, this type of thinking is linked to a greater risk of becoming or staying depressed. <br><br> While reflection is a good thing, and may help you solve problems, rumination does the opposite. <br><br> If you catch yourself ruminating, studies suggest it may help if you try to distract yourself, meditate, or redirect your thoughts. Cognitive behavioral therapy often targets rumination because it can be so damaging to mental health.
Retire Your Crystal Ball
Very few (if any) of us are blessed with the ability to predict the future. But depressed people will often convince themselves they know what will happen a day, a month, or a year down the line. And it's usually bad, if not downright catastrophic. <br><br> Fortunately, our dire predictions rarely come true. <br><br> Try to stay in the present. It's much more manageable and you're less likely to blow things out of proportion.
Don't Dwell On The Past
It's pretty pointless to tell yourself you<em> should</em> have done this or <em>shouldn't</em> have done that. You can't change the past, but you can live in the present. <br><br> Just accept that you made the best decisions you could have made with the information or resources you had at the time. Hindsight is always 20/20, so best to try to just let it go and don't beat yourself up for perceived missteps. <br><br> And do a rumination check; ruminating about the past can generate anxiety, just as worry about the future.
Reach Out To Others
A hallmark of depression is isolation. It can happen easily if you're not working, or you're avoiding people because you're depressed. But reinvigorating or expanding a social network provides an opportunity to get support, perhaps even from people in the same or a similar situation, says Rego. <br><br> "Once you start reconnecting with people, you get a sense they understand," he says. "You get positive advice and encouragement and it's often done in activities that end up being fun." <br><br> Staying home alone will perpetuate the depression. Getting out with other people--even a little bit--will lift your spirits.
Stick To A Structured Routine
Even if you don't feel like it, make sure you get up at a set time, eat meals at the same hour every day (even if you're not hungry), and avoid lounging on the couch during the day lest it prevent you from sleeping well at night. <br><br> "People who are depressed tend to eat or sleep inconsistently," says Rego. "Even if you're unemployed or feeling down, it's really important to set and establish a daily routine as best you can. This gives you a sense of regularity that can help with a depressed mood." <br><br> If you can incorporate socializing into your routine, all the better.
Avoid Black And White Thinking
Black and white is great for zebras, but not thoughts. Depressed people tend to think in extremes: I'm a loser. No one loves me. I'll never get a job. <br><br> But your thought patterns could put you in a rut or keep you there. "Being depressed or sad is going to color the way you think about yourself in a negative direction," says Rego. <br><br> These thoughts can paralyze you and stop you from doing the very things that will get you out of a lousy situation. Try to think in shades of gray, says David R. Blackburn, PhD,a psychologist with Scott & White Hospital in Temple, Texas. Instead of "no one loves me," try "lots of people (if not everybody) love me."
Reality Check Your Thoughts
If you're depressed, negative thoughts go with the territory. However, they are rarely grounded in reality. <br><br> Once you've identified a negative thought, ask yourself, "Where is the evidence that I'm the most despicable human being on the entire earth?" There probably isn't any. <br><br> "You can't just be rattling these thoughts back and forth and saying they're true," says Blackburn. "You have to come up with some solid evidence." <br><br> And if you're worried about what people are thinking about you, go ahead and ask them.
Choose Smart Goals
Select a few simple, straightforward goals you can easily set and follow, suggests Rego. Those goals should be <em>SMART</em>, which stands for "specific, measurable, attainable, rewarding, and time-limited." <br><br> So for example, deciding you will have a job by the end of the week is unrealistic. <br><br> But deciding to post two resumes online by the end of the week, on the other hand, is <em>SMART</em>. "It's specific. It's attainable. It's not that much effort to do and it could be rewarding," says Rego.
Fake It A Bit
Write down all the things you used to like doing that you've stopped doing because you're sad and depressed, suggests Rego, who is also assistant professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine. <br><br> That could be going to the movies, socializing with friends, or simply going to the corner coffee shop with a newspaper. <br><br> Then, one by one, start reincorporating these activities into your life even if you're feeling unenthusiastic about it. Also, focus on tasks that can give you a sense of mastery or accomplishment, whether it's tidying up the apartment or paying the bills. That can help ease the depression as well. <br> <br><strong>More From Health:</strong> <br> <br><a href="http://www.health.com/health/gallery/0,,20515167,00.html" target="_hplink">12 Surprising Causes of Depression</a><br> <a href="http://www.health.com/health/gallery/0,,20581256,00.html" target="_hplink">Dos and Don'ts for Dealing with Anger</a><br> <a href="http://www.health.com/health/gallery/0,,20526304,00.html" target="_hplink">20 Celebrities Who Battled Depression</a><br>
Don't Deny Depression
If your present situation, well, sucks, denying it will only make things worse. "Some people don't accept they're depressed and instead beat themselves up or think they're crazy or weak," says Rego. <br><br> This may only drive you deeper down, while acceptance can relieve the suffering, he says. <br><br> In general, knowing and accepting that you're depressed can allow you to take steps to make it better or get treatment, rather than pretend that everything's just fine.
Treat Yourself Well
Take a look at the language you use when you think about or talk to yourself and compare it to the way you talk to everyone else. If there's a disconnect, try to treat yourself in a kinder, gentler way. <br><br> "We're often kind to everybody else but we beat ourselves up. That's a double standard," says Blackburn. "It would be preferable to use a single standard: Don't beat everyone else up, but get off your own back, too." <br> <br><strong>More From Health:</strong> <br> <br><a href="http://www.health.com/health/gallery/0,,20515167,00.html" target="_hplink">12 Surprising Causes of Depression</a><br> <a href="http://www.health.com/health/gallery/0,,20581256,00.html" target="_hplink">Dos and Don'ts for Dealing with Anger</a><br> <a href="http://www.health.com/health/gallery/0,,20526304,00.html" target="_hplink">20 Celebrities Who Battled Depression</a><br>