TREATMENT

 

Effective treatment and care of suicidal persons depends heavily on individuals’ level of risk, personal needs, and preferences. Approximately 90% of people who die by suicide have a mental disorder at the time of their death. Because of this, professionals widely agree that treating underlying mental disorders and assessing suicide risk are both vital elements in preventing suicide deaths.

Types of Treatment

Emergency Room

It is extremely important to seek treatment in any emergency situation. If you have attempted suicide and are hurt, call 9-1-1. Emergency rooms will treat any injuries, may ask you a series of questions, provide medication depending on your mental health status, and may ask you to stay in the hospital for further examination, observation, and to set up follow up care.

Other Ways to Seek Help in an Emergency

If you recognize the warning signs of suicide or are experiencing them yourself:

  • Dial 911 or the emergency number in your country.

  • Dial 1-800-273-TALK (8255) if in the United States or call your local crisis hotline agency.

  • Check into the hospital emergency room or urgent care.

  • Check in to your local psychiatric clinic.

  • Tell someone who can help you find help immediately.

  • Stay away from things that might hurt you.

Most people can be treated with a combination of antidepressant medication and psychotherapy. It’s important to seek treatment as soon as warning signs present themselves.

Primary Care Doctor

A family or primary care doctor may be the only person to have access to a suicidal person or someone living with an undiagnosed mental illness. It’s known that almost 75 percent of people that died by suicide had seen their primary care doctor in the months leading up to their death. It’s essential primary care providers are trained to assess the mental well being of their patients.

In-Patient Treatment

Hospitalization: What You Need to Know

Those experiencing a serious mental illness are generally at a greater risk for suicide and it is important to understand that hospitalization alone will not and does not prevent suicide. It takes time for medication and therapy to take effect and for recovery to begin. The involvement and advocacy of family and friends is an important and appropriate part of the treatment plan. The following suggestions provide a guideline for working with a treatment facility when a loved one is undergoing treatment for depression or another mental illness.

Admission

What is the policy on involving family members with the patient’s care and availability of staff to answer questions? Printed sheets that promise classes, sessions, etc. without a definite date or appointment specified to meet with a supervisor, nurse or doctor are of little or no use. If possible, set up an appointment, and obtain a name and phone number of someone who will be available to answer your questions throughout the duration of treatment, typically this will be a social worker. Ask the doctor or your contact what the treatment plan is, what has to change in the patient’s attitude, behavior, and physical characteristics before he or she is discharged and any additional questions you have regarding the patient’s care and treatment plan.

During Treatment

What, if any, is your role and how can you assist the patient in this process? If you have questions or disagree with any decisions at any time, it’s very important you discuss them with the doctor or the treatment team. You know the patient better than the doctor and staff, and may be able to shed light on important issues. Patients may not recognize behavior changes because they’re ill; the doctor and staff may not recognize differences, especially if they’re not familiar with the patient. You are the best person to observe and state anything you are concerned about. Don’t be afraid to ask specific questions about how the patient’s treatment is progressing, i.e. is the patient participating in group or individual therapy, or both; are they interacting with students, interns, registered nurses, practical nurses, doctors, etc. This may determine the quality and value of care the patient is receiving.

Discharge

Some treatment facilities have a release or discharge meeting with the staff, patient and significant others, some do not. You can request a discharge meeting to determine if the patient is ready to leave and if they are healthy enough to manage their own care, or are able to obtain care from some other source. A continuing treatment plan is a necessity. In addition, if there is a difference between the planned and actual discharge, ask the doctor to review any changes in the patient during that time. Check with the patient and staff to see if written goals have been established. You can help the patient arrive at some constructive short-term goals for solving specific problems. Your interest will show the person you care. The patient should have specific goals in writing before leaving the treatment facility. Help locate and evaluate outside resources such as ministers, relatives and friends who can help in the recovery process. Continuing observation and support are vital and follow-up is crucial to ensure a successful recovery.

Medication

Antidepressants, antipsychotic medications, anti-anxiety medications and other medications for mental illness can help reduce symptoms, which can help individuals feel less suicidal. Clozapine is the only medication currently approved by the FDA to reduce the risk of a suicidal person.

Psychotherapy

Psychotherapy is one commonly effective treatment often prescribed to patients with depression. Professionals using different forms of psychotherapy have typically received formal training to perform the type of therapy they are delivering to the patient. Psychotherapy, generally speaking, is an intense form of interactive talk therapy between the patient and therapist usually a couple times a week for typically an extended period of time (12-16 weeks). Two common types of psychotherapy include cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).

Cognitive Behavioral Therapy is used for treating mood disorders, anxiety disorders, eating disorders, substance abuse disorders,  and others by examining the relationship between thoughts, feelings, and behaviors. This is accomplished by talking with a patient to uncover unhealthy thought patterns and construct new thought patterns that better serve the patient.

Dialectical Behavioral Therapy is heavily based on the same principles as CBT but instead uses acceptance and coming to terms with chronic negative thoughts and behaviors and uses that as a foundation to build balance and make positive change seem possible. DBT is more often used in patients with chronic suicidal thinking and typically yields better results, seeing fewer negative behaviors carried out after therapy.

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