Suicide often goes undiscussed. It’s a delicate issue for many people, and others prefer to push it away in hopes of forgetting about it. Unfortunately, ignoring the problem isn’t a solution. In the United States, suicide is the 10th leading cause of death. Nearly 43,000 Americans commit suicide each year. That’s over 100 per day – and for every successful suicide, another 25 are attempted.
People who are at risk of suicide require special care. Their situations are unique compared to other mental distresses and they’re potentially sensitive. This calls for effective, prompt, and proven treatments. Since each case means a life is at stake, it’s important to choose paths that are well researched and universally effective. These solutions are either evidence-based interventions or research-informed interventions. Studies show that both tactics are valid.
Evidence-Based Interventions For Suicide Risk
Historically, these tactics were designed to suicide risk target directly. Their effectiveness has been measured and documented, which generally makes mental health professionals favor the tactics, especially for high-risk patients. Three main interventions fall into this category:
- Non-demand caring contacts
- Problem-solving and structured therapies
- Assessment and treatment planning
Before a decision about which approach to take, it’s important to consider the individual patient’s needs. The tactic should center on the person, collaborate with health care providers, and acknowledge the feelings the individual is experiencing. Ambivalence is a delicate balance – one struck between the innate desire to continue living and a need for relief from pain and stress. This is one of the most important things to consider regardless of the chosen therapy.
Non-Demand Caring Contacts
The evidence supporting this intervention is growing. In this method, contacts at the facility are established during treatment. After discharge, these contacts will reach out to patients and help stay them engaged, follow up on their mental conditions, and extend the favorable connection between patient and provider.
These interactions are meant to be comfortable for the patient – hence “non-demand.” Many offices will implement this strategy in simple ways, such as letters and postcards, phone calls, text messages, and occasional in-person contact. Some organizations can also take advantage of automated systems to send these messages so that no patient is forgotten.
Cognitive Behavioral Therapy And Dialectical Behavior Therapy
Cognitive therapy has proven itself time and time again when it comes to improving mental states and health. This intervention is referred to as CBT-SP (SP for suicide prevention). Studies have shown reduction in symptoms and a drop in the number of suicide attempts. Some of the applications for cognitive behavioral therapy are:
- Restructuring strategies – These practices help identify, evaluate, and change a patient’s thought patterns.
- Techniques for Regulating Emotions – Many patients experience fewer symptoms when they’re taught how to manage urges, reactions, choices, and distress.
- Problem-Solving and Other Strategies – These generalized exercises vary, depending on the patient, but they can help provide an overall healthier mind.
Dialectical behavior therapy works in a similar fashion. “Dialectical” refers to the synthesis between opposites. In this case, using acceptance to see change provides visible results. The first component is a group meeting to train and develop skills. These sessions run for a significant time, usually one meeting per week for four months. Afterward, patients will be exposed to individual treatment and phone coaching (upon request). Another facet of dialectical behavior therapy is that consultation teams meet with each other to discuss new strategies and improve their regimens.
Collaborative Assessment And Management Of Suicidality
Outpatient care is the goal of this intervention. Collaborative assessment and management of suicidality (CAMS) is engineered to improve therapeutic alliance and boost patients’ motivation. The most important part of this technique is that the patient and provider collaborate with one another to assess and actively treat the individual. This method also allows the patient to feel a heightened sense of control and connection with the therapist.
There are six individual studies demonstrating the worth of this intervention. Overall, reduced suicidal ideas, decreased symptoms (such as depression and hopelessness), and increased optimism were all shown, with the strongest effects becoming visible 12 months into treatment.
Although a body of research doesn’t support these methods, they’re equally important for suicide prevention in many cases. Clinicians work alongside patients to develop strategies. Safety planning and lethal means removal are two of these interventions.
This intervention is a bit broader and helps keep high-risk patients more secure. It focuses on improving the patients’ environments, teaching them some coping skills, building emergency contacts, improving social support, and offering motivational material. This tactic is designed to enable patients to stay alive and remain positive in lieu of or while waiting for more in-depth training.
Lethal Means Removal
One of the most basic ways to keep patients safe is to remove their ability to hurt themselves. This tactic focuses on taking away any dangerous articles so that the individual won’t be tempted to hurt him or herself and can’t attempt suicide. Firearms, knives, chemicals, and medications are just a few of the things that suicide risk patients shouldn’t be able to access. This shouldn’t be the only prevention method, however, as building positive thought processes is important for the individual’s future.
There are many ways to intervene when dealing with a high-risk patient, and they’re all important. When someone’s life is on the line, every choice can have a major impact.