Wednesday, November 7, 2012

Hopelessness and Suicide

At the women's prison I work at they have a new job, essentially life sentenced inmates who have had specialized training are now "observing" other inmates who are in segregation due to suicide (talk of it, paraphernalia or an attempt.)  This is a controversial plan; inmates watching other inmates and when necessary calling for an Officer.  The inmates who have just started this say more than anything it is boring; lots of downtime, odd shift hours- but they get paid for it and these are "mentors," in our program.  I spent part of this week talking to one of these inmates about her shift last night which began at 2am and she told me about the training and what she had learned about suicidal risk factors.  She did not mention the #1 risk factor for suicide, which is hard to assess as an observer- hopelessness.
From this amazing documentary interviewing people who jumped
Hopelessness is the despair you feel when you have abandoned hope of comfort or success.  I often refer to hopelessness of being in a black box and being able to see a way out.  Hopelessness is the #1 indicator of suicide; more than age, gender or even past attempts.  When someone does not see a way out, or things improving they are more likely to hurt themselves.
The Beck Hopelessness Scale is a 20-item self-report inventory developed by Dr. Aaron Beck. It is designed to measure three major aspects of hopelessness: feelings about the future, loss of motivation, and expectations. The test is designed for adults aged 17 – 80.Individuals completing the scale are asked to answer the questionnaire based on their attitudes during the preceding week. It may be administered in written or oral form, and each item is scored with a true/false. Total scores range from 0-20 with higher scores indicating a greater degree of hopelessness. 
Beck’s cognitive model of depression focuses on a “cognitive triad” which includes negative thoughts about self, the world/environment, and the future. Hopelessness is the experience of despair or extreme pessimism about the future. As such, hopelessness is part of the “cognitive triad” of depression, but it also plays an important role in predicting suicide. [source]
Although I typically advise against taking any online quizzes to determine any mental health diagnosis, there is a copy of the "test" here if you are interested to see where you might be at this moment on the scale.  I would advise that if you feel you are at risk for hurting yourself you immediately call your local crisis line or go to the hospital to keep yourself safe.

I always tell client's who are suicidal, that by taking their own life they won't ever know if it gets better; their mood improves naturally, situation at home/relationship change or if new medications will hit the market.  They will never know what their life is going to be like in 2 or 20 years, if they end it right now.

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