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We all have a mental picture of who we are, how we look, what we're good at, and what our

weaknesses might be. We develop this picture over time, starting when we're very young. The

term self-image is used to refer to a person's mental picture of himself or herself. A lot of our self-

image is based on interactions we have with other people and our life experiences. This mental

picture our self-image! contributes to our self-esteem .

"elf-esteem is all about how much we feel valued, loved, accepted, and thought well of by others

# and how much we value, love, and accept ourselves. $eople with healthy self-esteem are able

to feel good about themselves, appreciate their own worth, and take pride in their abilities, skills,

and accomplishments. $eople with low self-esteem may feel as if no one will like them or accept

them or that they can't do well in anything.

Commit suicide

How to Respond to a Suicidal ClientInstructions

1.

o 1Make sure the client is safe. This will depend on the setting. If you are in an emergencyroom, medical or psychiatric hospital, the client can be put under observation to ensureimmediate safety. If the client is not in an inpatient setting but is actively suicidal, wherethey can't stop thinking about hurting themselves, then they need to go to an emergencyroom or inpatient psychiatric setting. You may need to call an ambulance. If the client ispassively suicidal, having had thoughts of hurting themselves but no current plan orintent, then you may want to continue to discuss these thoughts, but emergencyhospitalization may not be re uired.

o 2 !ssess the client's risk. This involves talking to the client and possibly collateral contactssuch as family members, friends and other health care providers. !sk about risk factorsfor suicide. These include current thoughts or ideation, substance abuse, feeling hopelessor helpless, an"iety, social isolation, an underlying mental illness, past suicide attempts,family history of suicide, family history of abuse and history of aggressive behaviors.#ther factors that may increase risk of suicide include age and gender$ people betweenthe ages of %& and ( are more likely to commit suicide and men are more likely tocommit suicide successfully. !nother important risk factor is access to lethal methods )) whether the client has a plan and the ability to put that plan into action. The number ofrisk factors and their severity will lead to both an immediate safety plan as well as a long)term treatment plan.

o

o 3 !ssess the client's protective factors. !lthough these factors will not necessarily negaterisk factors, they can be helpful in creating a treatment plan as they allow you to work with the strengths and supports that the client already has in place. *rotective factors to

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look for include effective support for mental, physical and substance abuse disorders,family, community and social support, ability to solve problems in a non)violent way andcultural beliefs that discourage suicide.

What Should a Counselor Do for a SuicidalClient?

By Donna Torney, eHow Contributor

No one, not even mental health professionals, can ever predict with 100 percentaccuracy whether a person will attempt suicide. However, certain screening questionscan help counselors discern if a client is actively considering suicide. Once it has beenestablished that a client is contemplating suicide, counselors can take action, workingwith clients to find alternatives ways of coping and getting through the suicide crisis.

At Risk• +ertain individuals are at higher risk for trying and successfully completing

suicide. Men are four times more likely than woman to die from suicide. The presence ofa mental disorder or substance abuse also increases the risk that a client will try suicide.*eople older than &, as a group, have the highest number of attempted suicides, andclients with prior suicide attempts or a family history of suicide are also at increased risk.

Screening For Safety• ! good suicide screening should include uestions that clarify whether a patient

has a plan and the means to carry out the plan. The more detailed the plan, especially ifthe client has access to weapon or other means, the more seriously the counselor shouldtake the threat of suicide. In addition, counselors should interview clients about theirsupport systems and look for signs of isolation. -ome suicidal clients will talk aboutsaying goodbye to loved ones, will give away possessions or otherwise get their affairs inorder and will talk about these activities in counseling. owever, the signs can be muchmore subtle. ! recent loss, such as a breakup of a relationship or a death of a loved one,might also instill a feeling of hopelessness that could lead to suicidal thoughts. /ith thepresence of any of the above signs, counselors should work with clients to create a planfor safety. This can include a detailed list of friends, relatives or community supportgroups for the client to call, as well as information about reaching local emergencyservices or suicide hotlines, such as the 0ational -uicide *revention otline, %)122) 34)T!56 71 &&8. ! team approach to working through a suicide crisis can also increase theclient's safety. /henever in doubt, counselors should work together with psychiatristsand other medical professionals to help stabilize clients.

•

Instilling Hope• -uicide is about lost hope, and the counselor's 9ob is to help client's regain hope.

#nce clients are out of crisis and are no longer actively suicidal, counselors can work

with clients to regain meaning in their lives. ! study published in the :ournal of the !merican Medical !ssociation showed that cognitive therapy, a type of talk therapy in

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which counselors help clients identify and reframe negative and counterproductivethinking, reduced repeated suicide attempts by &2 percent. ;y using these techni uesand working with a team and the client to set specific goals, counselors can help clientsfind better solutions and renew optimism.

How to Handle Suicidal ClientsBy R.A. Anderson, eHow Contributor

hen a client admits to feeling suicidal, it is important to react quickly and to handlethe situation with discretion. Handling the situation improperly may lead to harm toyour client and legal and professional problems for you. !f you work in an industrywhere suicidal clients are common, ask your supervisor or human resourcesdepartment about training programs that can help you learn appropriate techniques for handling suicidal clients.

Instructions1.

o 1<ollow your company's internal policies regarding suicidal clients. If your workplacealready has procedures in place about how to handle suicidal clients, work under thoseguidelines.

o 2Take all suicidal threats and ideations seriously. =ven if you don't think your client isserious about following through with her suicide threat, take it seriously and do notdismiss her feelings or say anything to minimize her pain.

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o 35isten to what the client has to say. -uicidal people often feel alone and do not believethat anyone wants to hear about their problems. !lthough it will not provide a long)termsolution to your client's pain, take the time to listen to her. 5et her e"plain what she isfeeling and what led up to the suicidal ideations.

o 4elp the client find appropriate and immediate treatment. If you have not been formally

trained in crisis intervention or do not feel e uipped to handle her suicidal threats, help your client get professional services. @se your company's resources to help her gettransportation to an emergency room or psychiatric hospital.

o 5

/rite a detailed memo about the client's situation and present it to the appropriateparties. !lthough it is important to respect your client's privacy, inform your supervisor

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about the situation. If you have a waiver to speak to your client's psychiatrist, contacthim as well.

o 6<ollow up on the situation. !fter you have ensured that your client is in a safe place andis seeking treatment, continue to work with her resolve the issues that led to the suicidalfeelings.

What is Suicide & How toIntervene

Introduction

After accidents and homicides, suicide is the third leading cause of death among young adults ages

%&- (. )t can be prevented. *en are more likely to commit suicide than women. They usually use

violent means to end their own lives. +emales, on the other hand, are more likely to attempt

suicide. They usually use drugs or poison to try and end their lives. ou should note that a suicide

attempt is a cry for help and a re uest for social support. The suicidal person is letting his/her

feelings be known. 0is/her problems seem overwhelming and too difficult to handle.

Why do College Students Kill Themselves?

1ecause each individual is uni ue there is no single reason as to why a student commits suicide.

0owever, there are several factors that may contribute to a student having suicidal thoughts.

These include2*a3or life transition, such as loss of a loved one, breaking up with a boyfriend/girlfriend,

moving to a new town or school, failing an exam or course, not getting into one's choice of

ma3or, etc. These ma3or life changes can cause a college student to feel unloved, depressed,

isolated and lonely.

+eelings of hopelessness and helplessness. $roblems in living seem more than one can

bear. 4o matter what one does things do not seem to be getting better and no one seems to

care or can help.

4egative feelings about oneself. A student who is suicidal experiences feelings of

worthlessness and of being a failure. 0e/she may not be doing well in school or may not beexcelling in academic or social areas that are of interest.

Wanting to end unbearable pain/problems that are so overwhelming.

Alcohol and substance abuse can cause a student to lose self control and engage in

impulsive suicidal behaviors.

4ote that depression is a ma3or contributing factor to suicidal thinking. 5epression may result from

several factors, including the recent loss of a family member or friend, disappointments in

romantic relationships, or failure to live up to one's own or others expectations.

Myths and Facts About Suicide

There are many myths about suicide2MYTH

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Asking a student if he/she is thinking about suicide will put the idea into his/her head.

6nce a student decides to commit suicide there is no way of stopping him/her.

"uicide happens without warning.

"tudents who commit suicide are mentally ill.

FACT

5iscussing the problem openly shows the suicidal student that someone cares and wants

to help.

*ost students who are suicidal do not want to die. They are making a cry for help .

7&8 of the people who attempt or commit suicide have shown some warning sign s!.

"tudents who are suicidal are not necessarily mentally ill.

Warning Signs

There are verbal and non-verbal warning signs of suicide that will let you know that your

classmate or friend is crying for help.NON-VERBAL warning signs include:

9iving away personal or pri:ed possessions.

)ncreased alcohol or drug use.

"leeping too much or too little.

;ack of interest in personal appearance.

;ack of interest in friends.

;ack of interest in social activities that were formerly of interest.

$oor performance in school.

1oredom, restlessness, and loss of concentration.

$lease note that many of these warning signs are signs of depression. 5epression does not

necessarily mean that a person is contemplating suicide. 1ut depressed people often think of

suicide.VERBAL warning signs include such negati e state!ents as:

)nstructors, classmates, families and friends do not care.

;ife isn't worthwhile.

$eople are better off without me.

<verything seems to be going wrong.

) don't need this any more.

Ways to Help

Talk openly and freely and ask direct uestions about the student's intention.

;isten to what is said and treat it seriously. 5o not add to your friend/classmate's guilt by

debating, arguing or lecturing about whether or not suicide is right or wrong.

4<=<> leave a student who is suicidal alone.

<ncourage the student to seek help.

9et help immediately.

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6 reasons why people commit suicideby ALEX LICKERMAN, MD on "une #rd, $010in CONDITIONS

Though I !e ne!er "ost a #riend or #a$i"y $e$ber to sui%ide, I ha!e "ost a patient.

I ha!e known a nu$ber o# peop"e "e#t behind by the sui%ide o# peop"e %"ose to the$, howe!er. &i!en how

$u%h "osing $y patient a##e%ted $e, I !e on"y been ab"e to guess at the de!astation these peop"e ha!e

e'perien%ed. (ain $i'ed with gui"t, anger, and regret $akes #or a bitter drink, the taste o# whi%h I !e seen

take $any $onths or e!en years to wash out o# so$e $ouths.

The one )uestion e!eryone has asked without e'%eption, that they a%he to ha!e answered $ore than any

other, is si$p"y, why*

+hy did their #riend, %hi"d, parent, spouse, or sib"ing take their own "i#e* !en when a note e'p"aining the

reasons is #ound, "ingering )uestions usua""y re$ain- yes, they #e"t enough despair to want to die, but why

did they #ee" that* A person s sui%ide o#ten takes the peop"e it "ea!es behind by surprise on"y

a%%entuating sur!i!or s gui"t #or #ai"ing to see it %o$ing/.

(eop"e who !e sur!i!ed sui%ide atte$pts ha!e reported wanting not so $u%h to die as to stop "i!ing, a

strange di%hoto$y but a !a"id one ne!erthe"ess. I# so$e in0between state e'isted, so$e other a"ternati!e to

death, I suspe%t $any sui%ida" peop"e wou"d take it. or the sake o# a"" those reading this who $ight ha!e

been "e#t behind by so$eone s sui%ide, I wanted to des%ribe how I was trained to think about the reasons

peop"e ki"" the$se"!es. They re not as intuiti!e as $ost think.

In genera", peop"e try to ki"" the$se"!es #or si' reasons-

1. They’re depressed. This is without )uestion the $ost %o$$on reason peop"e %o$$it sui%ide. Se!ere

depression is a"ways a%%o$panied by a per!asi!e sense o# su##ering as we"" as the be"ie# that es%ape #ro$

it is hope"ess. The pain o# e'isten%e o#ten be%o$es too $u%h #or se!ere"y depressed peop"e to bear. The

state o# depression warps their thinking, a""owing ideas "ike 2 !eryone wou"d a"" be better o## without

$e3 to $ake rationa" sense. They shou"dn t be b"a$ed #or #a""ing prey to su%h distorted thoughts any

$ore than a heart patient shou"d be b"a$ed #or e'perien%ing %hest pain- it s si$p"y the nature o# their

disease.

Be%ause depression, as we a"" know, is a"$ost a"ways treatab"e, we shou"d a"" seek to re%ogni4e its

presen%e in our %"ose #riends and "o!ed ones. 5#ten peop"e su##er with it si"ent"y, p"anning sui%ide without

anyone e!er knowing. Despite $aking both parties un%o$#ortab"e, in)uiring dire%t"y about sui%ida"

thoughts in $y e'perien%e a"$ost a"ways yie"ds an honest response. I# you suspe%t so$eone $ight be

depressed, don t a""ow your tenden%y to deny the possibi"ity o# sui%ida" ideation pre!ent you #ro$ asking

about it.

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. They’re psychotic. 6a"e!o"ent inner !oi%es o#ten %o$$and se"#0destru%tion #or uninte""igib"e reasons.

(sy%hosis is $u%h harder to $ask than depression 7 and arguab"y e!en $ore tragi%. The wor"dwide

in%iden%e o# s%hi4ophrenia is 18 and o#ten strikes otherwise hea"thy, high0per#or$ing indi!idua"s, whose

"i!es, though $anageab"e with $edi%ation, ne!er #u"#i"" their origina" pro$ise.

S%hi4ophreni%s are 9ust as "ike"y to ta"k #ree"y about the !oi%es %o$$anding the$ to ki"" the$se"!es as

not, and a"so, in $y e'perien%e, gi!e honest answers about thoughts o# sui%ide when asked dire%t"y.

(sy%hosis, too, is treatab"e, and usua""y $ust be #or a s%hi4ophreni% to be ab"e to #un%tion at a"". :ntreated

or poor"y treated psy%hosis a"$ost a"ways re)uires hospita" ad$ission to a "o%ked ward unti" the !oi%es

"ose their %o$$anding power.

!. They’re impulsi"e. 5#ten re"ated to drugs and a"%oho", so$e peop"e be%o$e $aud"in and i$pu"si!e"y

atte$pt to end their own "i!es. 5n%e sobered and %a"$ed, these peop"e usua""y #ee" e$phati%a""y asha$ed.

The re$orse is usua""y genuine, and whether or not they "" e!er atte$pt sui%ide again is unpredi%tab"e.

They $ay try it again the !ery ne't ti$e they be%o$e drunk or high, or ne!er again in their "i#eti$e.

Hospita" ad$ission is there#ore not usua""y indi%ated. Substan%e abuse and the under"ying reasons #or it

are genera""y a greater %on%ern in these peop"e and shou"d be addressed as aggressi!e"y as possib"e.

#. They’re cryin$ out for help% and don’t &now how else to $et it. These peop"e don t usua""y want to

die but do want to a"ert those around the$ that so$ething is serious"y wrong. They o#ten don t be"ie!e

they wi"" die, #re)uent"y %hoosing $ethods they don t think %an ki"" the$ in order to strike out at so$eone

who s hurt the$7but are so$eti$es tragi%a""y $isin#or$ed. The prototypi%a" e'a$p"e o# this is a young

teenage gir" su##ering genuine angst be%ause o# a re"ationship, either with a #riend, boy#riend, or parent

who swa""ows a bott"e o# Ty"eno"7not rea"i4ing that in high enough doses Ty"eno" %auses irre!ersib"e"i!er da$age.

I !e wat%hed $ore than one teenager die a horrib"e death in an IC: days a#ter su%h an ingestion when

re$orse has a"ready %ured the$ o# their desire to die and their true goa" o# a"erting those %"ose to the$ o#

their distress has been a%hie!ed.

'. They ha"e a philosophical desire to die. The de%ision to %o$$it sui%ide #or so$e is based on a

reasoned de%ision o#ten $oti!ated by the presen%e o# a pain#u" ter$ina" i""ness #ro$ whi%h "itt"e to no

hope o# reprie!e e'ists. These peop"e aren t depressed, psy%hoti%, $aud"in, or %rying out #or he"p. They re

trying to take %ontro" o# their destiny and a""e!iate their own su##ering, whi%h usua""y %an on"y be done in

death. They o#ten "ook at their %hoi%e to %o$$it sui%ide as a way to shorten a dying that wi"" happen

regard"ess. In $y persona" !iew, i# su%h peop"e are e!a"uated by a )ua"i#ied pro#essiona" who %an re"iab"y

e'%"ude the other possibi"ities #or why sui%ide is desired, these peop"e shou"d be a""owed to die at their

own hands.

6. They’"e made a mista&e. This is a re%ent, tragi% pheno$enon in whi%h typi%a""y young peop"e #"irt

with o'ygen depri!ation #or the high it brings and si$p"y go too #ar. The on"y de#ense against this, it

see$s to $e, is edu%ation.

The wounds sui%ide "ea!es in the "i!es o# those "e#t behind by it are o#ten deep and "ong "asting. Theapparent sense"essness o# sui%ide o#ten #ue"s the $ost signi#i%ant pain sur!i!ors #ee". Thinking we a"" dea"

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better with tragedy when we understand its underpinnings, I !e o##ered the pre%eding paragraphs in hopes

that anyone reading this who s been "e#t behind by a sui%ide $ight be ab"e to $ore easi"y #ind a way to

$o!e on, to re"in)uish their gui"t and anger, and #ind %"osure. Despite the abrupt way you $ay ha!e been

"e#t, those don t ha!e to be the on"y two e$otions you re doo$ed to #ee" about the one who "e#t you.

Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in

this +or"d .

Submit a guest post and be heard .TM > Counselling Centre > DID YOU KNOW > Bunuh Diri: Apa Yang Perlu Anda Tahu

BUNUH DIRI: APA YANG PERLU ANDA TAHU• Share This:

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• 5elicious?une @, @%%written by pkk

4ampaknya ke3adiah bunuh diri di *alaysia sudah semakin meruncing. Apa tidaknya, menurutTimbalan *enteri esihatan, 5atuk >osnah Abdul >ashid "hirlin, seramai 7B% individu dilaporkantelah membunuh diri di negara kita se3ak @@7. )tu bukan 3umlah yang sedikit. 5ari 3umlahsebanyak itu, &(& dari angka itu adalah lelaki dan selebihnya adalah wanita iaitu sebanyak %CD

orang. 5aftar "tatistik 1unuh 5iri ebangsaan *alaysia pula menun3ukkan B % kes melibatkanpasangan berkahwin, E bercerai, B( balu dan EC kes golongan bu3ang. ?ika kita memandang

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pada se3arah yang lalu, purata 3umlah kes bunuh diri di *alaysia dalam sehari sa3a sudahmencapai 7 orang. )tu tahun @@&. "aya yakin, setelah lebih kurang D tahun berlalu, angkanyasudah tentu meningkat berdasarkan faktor kehidupan yang semakin menekan. "ebagai individuyang prithatin, apa yang boleh kita lakukan bagi menangani isu bunuh diri iniF

"ebenarnya, dikatakan sebahagian besar dari individu yang ingin membunuh diri memberitahurancangan mereka. Ada yang menyatakan niat mereka dengan 3elas dan ada yang memberi kiasansa3a. ?ika rakan atau saudara anda ada memberitahu anda sesuatu dan ayat mereka lebih kurangserupa dengan ayat dibawah ini, nasihat saya, ber3aga-3agalah, mereka mungkin mempunyai niatuntuk membunuh diri2

• 0idup ni sia-sia sa3a• eluarga atau kawan/kekasih! lebih bahagia tanpa saya

• Ambillah barang-barang/koleksi saya ni. "aya dah tak perlukannya.

• Awak pasti menyesal bila saya tiada nanti.

• "aya takkan bersama awak tak lama lagi.

• "aya tak dapat nak hadapi semua ini. 0idup ini susah sangat.

• "aya tak akan 3adi beban awak lagi lepas ni.

• "emua orang tak faham saya. "emua orang tak dapat rasa apa yang saya rasa.

• ;ebih baik saya mati sa3a.

• "aya rasa seperti tiada 3alan keluar.

• 0idup awak lebih baik tanpa saya.

1unuh diri adalah salah satu simptom yang serius bagi individu yang mengalam tekanande"ressi#n ! yang teruk. Antara tanda-tanda tekanan adalah2

• >asa sedih dan tertekan• $erubahan pada pola atau corak tidur contohnyaG tidur terlalu banyak atau sedikit atau

menghadapi masalah sukar tidur!

• $erubahan yang ketara pada berat badan dan selera makan

• 1ercakap dan/atau bergerak dengan kadar kecepatan/kelambatan diluar kebiasaan

• 0ilang rasa minat pada aktiviti-aktiviti yang biasa dilakukan contohG hobi, aktiviti luar

rumah, bersama-sama dengan rakan!

• *enarik diri atau men3auhkan diri dari keluarga dan kawan-kawan

• >asa letih dan kehilangan tenaga

• emampuan untuk berfikir dan fokus yang semakin berkurangan, lambat berfikir dan

men3adi ragu-ragu.

•

*erasa diri tidak berguna, sia-sia dan rasa bersalah

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• *emikirkan tentang kematian, tentang cubaan bunuh diri dan mengharapkan pada

kematian

?adi, 3ika anda berhadapan dengan individu yang ingin membunuh diri2

• 1awalah mereka ke tempat selamat agar mudah untuk mereka meluahkan masalah atauanda boleh yakinkannya untuk membawanya ber3umpa dengan kaunselor, pegawai psikologidan psikiatri untuk tu3uan itu.

• Huba bercakap dengan mereka agar mereka dapat meluahkan perasaan

• ?angan pandang remeh niat mereka untuk membunuh diri.

• ?angan asyik memberi nasihat. *ereka sebenarnya ingin anda mendengar listen ! masalah

yang dialami

• ?angan cuba menilai tingkahlaku mereka kerana anda tidak mengerti dan tidak berada

disituasi mangsa.

• ?angan mengatakan Ianda patutJ kerana ini akan menyebabkan mereka mersa lebih

bersalah dan merasa diri lebih gagal men3alankan sesuatu tanggung 3awab

"emoga apa yang dipaparkan kali ini memberi manfaat pada anda semua. "ebarang pertanyaan,idea dan pandangan sentiasa dialu-alukan

Kadar Bunuh Diri Meningkat Di MalaysiaOleh JOSEPH SIPALAN

PUT AJA!A" Kadar kematian akibat bunuh diri semakin meningkat di Malaysia, dengan lebih daripada 1,000orang mati dalam tempoh tiga tahun.

Menteri Kesihatan, Datuk Seri Lio !iong Lai berkata nisbah bunuh diri daripada "00# hingga "010 adalah 1.$bagi setiap 100,000 orang.

%&ni adalah berdasarkan angka yang kami perolehi daripada bedah siasat. Kami fikir kes bunuh diri kurangdilaporkan. Kami rasa terdapat kes yang tidak dilaporkan,% katanya selepas mempengerusikan mesyuarat Ma'lis(enasihat (romosi Kesihatan Mental di sini.

Daripada 11)* orang yang membunuh diri dalam tempoh tiga tahun, ma'oriti berusia antara "+ dan ++.

Lio berkata angka itu adalah membimbangkan kerana mangsa terdiri daripada kalangan kumpulan umurproduktif.

%Statistik kebangsaan 'uga menun'ukkan baha a lelaki melebihi bilangan kaum anita $ 1, manakala orang -inapula mempunyai bilangan tertinggi bunuh diri pada + /, diikuti oleh &ndia "1/ , Melayu 1 / dan kaum kaumlain 1$/ ,% katanya.

2agaimanapun, beliau berkata kadar bunuh diri di negara ini adalah 'auh lebih rendah berbanding purata globaliaitu 1* bagi setiap 100,000 orang.